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Yan L, Deng Y, Chen J, Hu Y, Hong S, Jiang L. Clinical and electroencephalography characteristics of 41 children with epileptic spasms onset after 1 year of age. Epilepsy Behav 2022; 135:108902. [PMID: 36081241 DOI: 10.1016/j.yebeh.2022.108902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/21/2022] [Accepted: 08/23/2022] [Indexed: 11/03/2022]
Abstract
The incidence of epileptic spasms (ES) that begin after the first year of life is much lower than that before 1 year of age. The aim of this study was to identify clinical and electroencephalography (EEG) characteristics, etiologies, treatments, and prognoses in pediatric patients with ES onset after 1 year of age. Forty-one children were retrospectively identified in Children's Hospital of Chongqing Medical University between January 1, 2020 and December 1, 2021. ES onset after 1 year of age have diverse presentations. Although most occur in clusters, are symmetrical and flexional, and occur frequently during awakening, some are characterized as isolated and asymmetrical, have a tonic component, and can also occur during sleep. The hypsarrhythmia variants and focal or multifocal discharges occur alternately in the interictal period, and the focal spikes and slow waves predominated in the unilateral temporal or frontotemporal areas. These patients had diverse etiologies, including structural (51.2 % of patients) and genetic (22.0 %) ones, and 11 patients (26.8 %) had an unknown etiology. No patients in our study had an infectious or immune-mediated etiology. Forty-eight percent of patients responded to hydrocortisone and/or adrenocorticotropic hormone. The efficacy of antiepileptic drug therapy was lower in patients who did not receive concurrent steroid therapy. However, ES onset after 1 year of age caused by a tumor, brain malformation, or other focal lesions, may be cured by focal cortical resection despite a lack of clearly localized EEG surface anomalies. Delays in motor, language, and cognitive development, or behavioral problems were observed in all but three patients.
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Affiliation(s)
- Lisi Yan
- Department of Neurology, Children's Hospital of Chongqing Medical University, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; Ministry of Education Key Laboratory of Child Development and Disorders, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; National Clinical Research Center for Child Health and Disorders (Chongqing), NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; Chongqing Key Laboratory of Pediatrics, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China
| | - Yu Deng
- Department of Neurology, Children's Hospital of Chongqing Medical University, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; Ministry of Education Key Laboratory of Child Development and Disorders, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; National Clinical Research Center for Child Health and Disorders (Chongqing), NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; Chongqing Key Laboratory of Pediatrics, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China
| | - Jin Chen
- Department of Neurology, Children's Hospital of Chongqing Medical University, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; Ministry of Education Key Laboratory of Child Development and Disorders, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; National Clinical Research Center for Child Health and Disorders (Chongqing), NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; Chongqing Key Laboratory of Pediatrics, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China.
| | - Yue Hu
- Department of Neurology, Children's Hospital of Chongqing Medical University, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; Ministry of Education Key Laboratory of Child Development and Disorders, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; National Clinical Research Center for Child Health and Disorders (Chongqing), NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; Chongqing Key Laboratory of Pediatrics, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China
| | - Siqi Hong
- Department of Neurology, Children's Hospital of Chongqing Medical University, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; Ministry of Education Key Laboratory of Child Development and Disorders, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; National Clinical Research Center for Child Health and Disorders (Chongqing), NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; Chongqing Key Laboratory of Pediatrics, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China
| | - Li Jiang
- Department of Neurology, Children's Hospital of Chongqing Medical University, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; Ministry of Education Key Laboratory of Child Development and Disorders, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; National Clinical Research Center for Child Health and Disorders (Chongqing), NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China; Chongqing Key Laboratory of Pediatrics, NO. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing 400014, China
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