Abstracts

Rationale: Infantile spasms is severe form of epileptic syndrome characterized by specific semiology, clustered spasms and electroencephalography patterns so called hypsarrhythmia. The prognosis of this disease is poor despite treatment. 70-80% of patients are mentally retarded and 23-54% of this disease evolves to Lennox-Gastaut syndrome. The aims of this study is to investigate the long term outcomes of infantile spasms. Methods: Of 356 patients who were diagnosed with infantile spasms at Severance children's hospital, Seoul, Korea, from 2006 to 2011, 98 patients with 5-year follow-up were qualified for evlauation. Retrospective electronic medical records review were conducted of 98 patients. Data were analyzed using IBM SPSS stastics version 19. Results: There were 39 female (39.8%) and 59 male (60.2%) patients. Mean age at the start of spasms was 7.82 (±5.68) month old. During 5-year follow-up, infantile spasms evoled to Lennox-Gastaut syndrome in 28 patients (28.5%), at the age of evolving state was 37.79 (±17.71) month old. The proportion of seizure freedom in 5 year follow-up was 66 of 98 (67.3%), and 32 of 98 patients couldn't achieve seizure freedom (32.7%). We applyed ketogenic diet treatment in 51 patients (52.0%), epileptic surgery in 13 patients (9 total corpus callosotomies, 3 lobectomies, 1 quadrantectomy, 12.2%), steroid therapies in 35 patients (35.7%). In 5-year seizure free group, 39 of 63 patients (61.9%) achieved seizure freedom on antiepileptic drug medication alone. 23 of 63 patients (36.5%) received ketogenic diet and medication treatment. 4 epileptic surgery (6.0%) were performed. In 5-year non-seizure free group, only 9 of 32 (28.1%) received medication treatment alone, 14 of 32 (43.7%) treated with medication and ketogenic diet, 9 of 32 patient (28.1%) received epileptic surgery. There were significant stastical differences in proportion of treatment modlaities between two group (p=0.02) but no definite stastical differences between seizure free and non-seizure free group in the etiology (p=0.3). Conclusions: In this study, we reported our treatment results in infantile spasms. We can understand that differences of the proportion of treatment modalities between two groups. But there were no significant differences in etiology between two groups. This is priliminary date, so we need further researches about outcomes of infantile spasms.