Early diagnosis and treatment of infantile spasms, a rare and severe type of seizure that occurs in young children, can help decrease the chance of developmental delay and future seizure disorders.
Infantile spasms can result from damage to a baby’s brain that occurs in the womb or from infections or brain injury; they also may be related to metabolic and genetic causes. They typically start within the first year of life, according to Anup D. Patel, MD, FAAN, a pediatric neurologist and director of the complex epilepsy clinic at Nationwide Children’s Hospital in Columbus, OH.
Parents or caregivers should look for these tell-tale signs of the disorder: a sudden stiffening of the muscles that initially lasts about one or two seconds, followed by less intense contractions that may last two to 10 seconds.
Typically, an infant may hunch forward with his or her arms extended, explains Dr. Patel, who also is professor of clinical pediatrics and neurology at the Ohio State University College of Medicine and president of the Child Neurology Foundation. Other symptoms include wide-eyed blinks and jerking of the torso, which sometimes can lead to a misdiagnosis of reflux, colic, or a startle reflex, according to the Infantile Spasms Action Network.
Infantile spasms are considered an urgent medical matter. If parents or caregivers believe their child has had infantile spasms, they should contact their primary care provider as soon as possible—ideally within a day of noticing the seizures, Dr. Patel says. “It is important that they are diagnosed early and treated.”
Doctors diagnose infantile spasms through a clinical exam and a routine, one-hour electroencephalogram (EEG)—a test that uses electrodes attached to the patient’s scalp to measure electrical activity in the brain—or an overnight EEG.
Treatment of infantile spasms involves one of three medications: prednisolone, a liquid given by mouth; adrenocorticotropic hormone, which is injected into the thigh; or vigabatrin, a solution mixed from a powder and given by mouth, Dr. Patel says. The American Academy of Neurology and Child Neurology Society recommend that treatment begin within a week of diagnosis, according to Dr. Patel.
“Children that respond to treatment (defined as no spasms and a normalized EEG) have a much better chance of not having seizures later in life and better development. If infants do not respond to treatment, they can go on to develop Lennox-Gastaut syndrome,” a difficult-to-treat epilepsy syndrome.
