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Infantile Spasms, Pediatric

John R. Mytinger, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Infantile spasms (IS) are seizures commonly associated with West syndrome—a severe infantile epileptic encephalopathy often with poor developmental outcome.

    • IS are characterized by su...

DIAGNOSIS

HISTORY

  • A description of spells including the timing of onset (single IS can precede clustering)

  • Prenatal and perinatal history including complications of pregnancy or delivery, gestational an...

TREATMENT

MEDICATION

First Line

  • Generally accepted 1st-line medical treatments include adrenocorticotropic hormone (ACTH), high-dose oral corticosteroids (HOC), and vigabatrin.

  • The etiology may determine...

ONGOING CARE

PROGNOSIS

  • Prognosis depends on the underlying etiology and associated conditions.

  • The best prognosis is typically for those with unknown etiology and normal development before diagnosis.

  • Abo...

ADDITIONAL READING

  • Baram TZ, Mitchell WG, Tournay A, et al. High-dose corticotropin (ACTH) versus prednisone for infantile spasms: a prospective, randomized, blinded study. Pediatrics.  1996;97(3...

CODES

ICD9

  • 345.60 Infantile spasms, without mention of intractable epilepsy

  • 345.61 Infantile spasms, with intractable epilepsy

ICD10

  • G40.822 Epileptic spasms, not intractable, w/o status epilepticus

  • G40.82...

FAQ

  • Q: Should I prescribe an abortive medication for longer clusters of IS?

  • A: Generally, No. IS do not typically respond acutely to benzodiazepines.

  • Q: My patient has IS and an abnormal EEG but no hyps...

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