Infantile epileptic spasms

Cute baby movements or is it infantile spasms in disguise? Learn what to look out for in today's episode!

This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Joanna Galindo (pediatric neurology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.

Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com

Key points:

• Infantile spasms are characterized by flexion of the trunk or neck and adduction or abduction of the arms, usually bilateral and symmetric in clusters and occuring in babies less than 1 years old
• Hypsarrhythmia on EEG is classic for infantile spasms and can help differentiate it from benign spasms of infancy or myoclonic epilepsy of infancy
• Treatment is with ACTH or high dose steroids and/or vigabatrin.

Sources:

• Pavone P, Polizzi A, Marino SD, et al. West syndrome: a comprehensive review. Neurol Sci. 2020;41(12):3547-3562. doi:10.1007/s10072-020-04600-5
• Go CY, Mackay MT, Weiss SK, et al. Evidence-based guideline update: medical treatment of infantile spasms [RETIRED]. Report of the Guideline Development Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2012;78(24):1974-1980. doi:10.1212/WNL.0b013e318259e2cf
• Riikonen R. Biochemical mechanisms in pathogenesis of infantile epileptic spasm syndrome. Seizure. 2023;105:1-9. doi:10.1016/j.seizure.2023.01.004