[A prognostic study of cryptogenic infantile spasms].
Identifieur interne : 001545 ( France/Analysis ); précédent : 001544; suivant : 001546[A prognostic study of cryptogenic infantile spasms].
Auteurs : J. Boulloche [France] ; P. Dautreme ; B. Le Luyer ; E. Mallet ; P. TronSource :
- Annales de pediatrie [ 0066-2097 ] ; 1991.
English descriptors
- KwdEn :
- Adrenocorticotropic Hormone (therapeutic use), Child, Preschool, Cosyntropin (therapeutic use), Developmental Disabilities (physiopathology), Electroencephalography, Female, Follow-Up Studies, Humans, Hydrocortisone (therapeutic use), Infant, Intellectual Disability (physiopathology), Intelligence, Male, Prognosis, Spasms, Infantile (drug therapy), Spasms, Infantile (physiopathology), Valproic Acid (therapeutic use).
- MESH :
- chemical , therapeutic use : Adrenocorticotropic Hormone, Cosyntropin, Hydrocortisone, Valproic Acid.
- drug therapy : Spasms, Infantile.
- physiopathology : Developmental Disabilities, Intellectual Disability, Spasms, Infantile.
- Child, Preschool, Electroencephalography, Female, Follow-Up Studies, Humans, Infant, Intelligence, Male, Prognosis.
Abstract
The prognosis of infantile spasms is grim when a detectable brain lesion is present. In contrast, cryptogenic infantile spasms, in which there is no identifiable brain lesion, usually run a favorable course under treatment. Few studies have focused on the outcome in children with cryptogenic infantile spasms. Among 111 pediatric patients with a history of infantile spasms hospitalized over 18 consecutive years, 23 (21%) were given a diagnosis of cryptogenic infantile spasms. Follow-up ranged from 4 to 21 years. Outcome was as follows: the IQ was above 80 in 39% of cases and above 100 in 13% of cases; 42% of patients of school age were attending school but half of these had learning disabilities; 30% of patients had severe psychiatric disorders, and 22% had developmental delay and severe epilepsia. Early factors apparently associated with a good prognosis included the mild nature of psychomotor regression, persistence of spindles on EEGs recorded during NREM sleep, and prompt improvement of clinical status and EEG recordings under treatment. Conversely, severe regression, focalized EEG anomalies, failure of development to resume promptly after initiation of therapy, recurrence of spasms and hypsarrhythmia at discontinuation of treatment, and onset before 5 months or after 11 years of age were associated with a poor prognosis.
PubMed: 1709342
Affiliations:
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pubmed:1709342Le document en format XML
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Le Luyer</name></author><author><name sortKey="Mallet, E" sort="Mallet, E" uniqKey="Mallet E" first="E" last="Mallet">E. Mallet</name></author><author><name sortKey="Tron, P" sort="Tron, P" uniqKey="Tron P" first="P" last="Tron">P. Tron</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1991">1991</date><idno type="RBID">pubmed:1709342</idno><idno type="pmid">1709342</idno><idno type="wicri:Area/PubMed/Corpus">000434</idno><idno type="wicri:Area/PubMed/Curation">000434</idno><idno type="wicri:Area/PubMed/Checkpoint">000434</idno><idno type="wicri:Area/Ncbi/Merge">000170</idno><idno type="wicri:Area/Ncbi/Curation">000170</idno><idno type="wicri:Area/Ncbi/Checkpoint">000170</idno><idno type="wicri:doubleKey">0066-2097:1991:Boulloche J:a:prognostic:study</idno><idno type="wicri:Area/Main/Merge">002514</idno><idno type="wicri:Area/Main/Curation">002449</idno><idno type="wicri:Area/Main/Exploration">002449</idno><idno type="wicri:Area/France/Extraction">001545</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[A prognostic study of cryptogenic infantile spasms].</title><author><name sortKey="Boulloche, J" sort="Boulloche, J" uniqKey="Boulloche J" first="J" last="Boulloche">J. Boulloche</name><affiliation wicri:level="3"><nlm:affiliation>Département de Pédiatrie, Centre Hospitalier, Le Havre.</nlm:affiliation><country>France</country><placeName><settlement type="city">Le Havre</settlement><region type="région" nuts="2">Région Normandie</region><region type="old region" nuts="2">Haute-Normandie</region></placeName><wicri:orgArea>Département de Pédiatrie, Centre Hospitalier</wicri:orgArea></affiliation></author><author><name sortKey="Dautreme, P" sort="Dautreme, P" uniqKey="Dautreme P" first="P" last="Dautreme">P. Dautreme</name></author><author><name sortKey="Le Luyer, B" sort="Le Luyer, B" uniqKey="Le Luyer B" first="B" last="Le Luyer">B. Le Luyer</name></author><author><name sortKey="Mallet, E" sort="Mallet, E" uniqKey="Mallet E" first="E" last="Mallet">E. Mallet</name></author><author><name sortKey="Tron, P" sort="Tron, P" uniqKey="Tron P" first="P" last="Tron">P. Tron</name></author></analytic><series><title level="j">Annales de pediatrie</title><idno type="ISSN">0066-2097</idno><imprint><date when="1991" type="published">1991</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adrenocorticotropic Hormone (therapeutic use)</term><term>Child, Preschool</term><term>Cosyntropin (therapeutic use)</term><term>Developmental Disabilities (physiopathology)</term><term>Electroencephalography</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Hydrocortisone (therapeutic use)</term><term>Infant</term><term>Intellectual Disability (physiopathology)</term><term>Intelligence</term><term>Male</term><term>Prognosis</term><term>Spasms, Infantile (drug therapy)</term><term>Spasms, Infantile (physiopathology)</term><term>Valproic Acid (therapeutic use)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Adrenocorticotropic Hormone</term><term>Cosyntropin</term><term>Hydrocortisone</term><term>Valproic Acid</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Spasms, Infantile</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Developmental Disabilities</term><term>Intellectual Disability</term><term>Spasms, Infantile</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Child, Preschool</term><term>Electroencephalography</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Infant</term><term>Intelligence</term><term>Male</term><term>Prognosis</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The prognosis of infantile spasms is grim when a detectable brain lesion is present. In contrast, cryptogenic infantile spasms, in which there is no identifiable brain lesion, usually run a favorable course under treatment. Few studies have focused on the outcome in children with cryptogenic infantile spasms. Among 111 pediatric patients with a history of infantile spasms hospitalized over 18 consecutive years, 23 (21%) were given a diagnosis of cryptogenic infantile spasms. Follow-up ranged from 4 to 21 years. Outcome was as follows: the IQ was above 80 in 39% of cases and above 100 in 13% of cases; 42% of patients of school age were attending school but half of these had learning disabilities; 30% of patients had severe psychiatric disorders, and 22% had developmental delay and severe epilepsia. Early factors apparently associated with a good prognosis included the mild nature of psychomotor regression, persistence of spindles on EEGs recorded during NREM sleep, and prompt improvement of clinical status and EEG recordings under treatment. Conversely, severe regression, focalized EEG anomalies, failure of development to resume promptly after initiation of therapy, recurrence of spasms and hypsarrhythmia at discontinuation of treatment, and onset before 5 months or after 11 years of age were associated with a poor prognosis.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Haute-Normandie</li><li>Région Normandie</li></region><settlement><li>Le Havre</li></settlement></list><tree><noCountry><name sortKey="Dautreme, P" sort="Dautreme, P" uniqKey="Dautreme P" first="P" last="Dautreme">P. Dautreme</name><name sortKey="Le Luyer, B" sort="Le Luyer, B" uniqKey="Le Luyer B" first="B" last="Le Luyer">B. Le Luyer</name><name sortKey="Mallet, E" sort="Mallet, E" uniqKey="Mallet E" first="E" last="Mallet">E. Mallet</name><name sortKey="Tron, P" sort="Tron, P" uniqKey="Tron P" first="P" last="Tron">P. Tron</name></noCountry><country name="France"><region name="Région Normandie"><name sortKey="Boulloche, J" sort="Boulloche, J" uniqKey="Boulloche J" first="J" last="Boulloche">J. Boulloche</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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