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Abstract
Background; Epileptic spasms (ES) is an epileptic encephalopathy occurring during infancy and early childhood. Early recognition and management is important to prevent severe neurological impairment. This study aimed at describing the clinical presentation, management and outcome of patients with Epileptic Spasms attending Muhimbili National Hospital (MNH), in Dar Es Salaam, Tanzania. Methods; A retrospective cross sectional study of all patients diagnosed with epileptic spasms was conducted at MNH from July 2016 to October 2018. Results; A total of 40 patients diagnosed with epileptic spasms were retrieved with male to female ratio of 3:2. In this study, 17 (42.5%) patients had a documented history of perinatal insult. The median age of onset of spasms was 5 months (IQR 1-12 months). In 15 (88%) out of 17 patients whom electroencephalography ( EEG) findings were retrieved had abnormal EEG findings showing either generalized epileptiform discharges 7(41%), generalized slowing 5(30%), hypsarrthymia 1(6%), or abnormal focal epileptiform discharges 2 (12%). Twenty-nine (73%) received prednisolone, with a median time of spasms subsiding of 1 month with a range of 10 days to 3 months in about 90% of them. Conclusion; The median age of onset of epileptic spasms at MNH is 5 months with the most common cause being perinatal insult in more than 40% of the patients. High dose prednisolone showed a good response in patients with epileptic spasms at MNH.
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References
2. Semiology S. Epileptic Spasms. 2018;(April):2010–3.
3. Shields WD. Infantile spasms: little seizures, BIG consequences. Epilepsy Curr [Internet]. 2006;6(3):63–9. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16761063%5Cnhttp://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC1464162
4. Asano E, Juhász C, Shah A, Muzik O, Chugani DC, Shah J, et al. Origin and propagation of epileptic spasms delineated on electrocorticography. Epilepsia. 2005;46(7):1086–97.
5. Pellock JM, Hrachovy R, Shinnar S, et al. Infantile spasms: a U.S. consensus report. Epilepsia 2010; 51:2175.
6. Kellaway P, Hrachovy RA, Frost JD Jr, Zion T Precise characterization and quantification of infantile spasms.Ann Neurol. 1979;6(3):214.
7. Hrachovy, RA; Frost JD (2003). "Infantile epileptic encephalopathy with hypsarrhythmia". Journal of Clinical Neurophysiology. 20 (6): 408–425.
8. Khatami A, Sell E, Aggag M, Miller E. Brain MRI Findings in Infantile Spasm: Outcome Correlations in a Patient Cohort. Open J Med Imaging. 2016;06(03):80–92.
9. Lux AL, Edwards SW, Hancock E, Johnson AL, Kennedy CR, Newton RW, et al. The United Kingdom Infantile Spasms Study comparing vigabatrin with prednisolone or tetracosactide in a randomised trial: developmental outcome at 14 months. Epilepsia [Internet]. 2004;45 Suppl 7:273‐274. Available from: https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00494700/full
10. Stand MBUS. PDF created with pdfFactory Pro trial version www.pdffactory.com PDF created with pdfFactory Pro trial version www.pdffactory.com. 2014;1–2.