Brain injury or structural defects are viewed as the most common infantile spasm causes. Scroll down to find out more about the causes and treatment options of this medical condition.
Epilepsy is a medical condition that is characterized by recurrent episodes of seizures. It is caused due to an abnormal electrical activity in the brain. An electrical disturbance in the brain gives rise to sudden changes in the behavior that range from spasms or convulsions to even loss of consciousness.
Seizure disorders can affect children and adults. West’s syndrome, is one such uncommon epileptic condition that affects infants in the age group of 3 to 12 months. The symptoms of this uncommon form of epileptic seizures in children were described by Dr. William James West in the early 1840s. This seizure disorder is also called age-dependent epilepsy. It is characterized by a particular pattern of spasms, wherein a sudden jerk is followed by stiffening of the infant’s body.
The child having such a spasm, may fling the arms open as his/her body bends forward. Though a spasm may last just for a couple of seconds, these spasms usually occur in clusters most of the time. A cluster of infantile spasms may range from a few spasms to more than a hundred spasms. In this article, we will look into infantile spasm causes along with the symptoms and treatment options.
Causes and Symptoms of Infantile Spasms
Besides the particular pattern of epileptic seizure, other features that are characteristic of this epileptic condition include an abnormal electroencephalographic pattern called hypsarrhythmia along with the risk of developmental delay or mental retardation. Infantile spasms are most commonly seen in infants with structural brain abnormalities. It is believed that malfunctioning of neurotransmitters or excessive production of corticotropin-releasing hormone may be contributing factors.
Trauma or oxygen deprivation during childbirth, brain injury, birth asphyxia, bacterial meningitis, congenital infections or vascular malformations are believed to be the common causes of infantile spasms. A child suffering from a genetic disorder called tuberous sclerosis may also be susceptible to West’s syndrome. Tuberous sclerosis is characterized by the formation of tumors in many parts of the body.
One may be genetically predisposed to this condition. Metabolic disorders or chromosomal defects could also make a child vulnerable to this condition. Many a time, a child may be diagnosed with a neurological disorder, but the direct cause of spasms may still not be known. Such a case of infantile spasms is referred to as a cryptogenic case.
Now that you have some idea about the causes, let’s move on to symptoms of infantile spasms. As mentioned earlier, the pattern of the spasm is characterized by a sudden jerky movement that causes the infant’s body to bend forward. This is followed by stiffening of the neck, torso, arms and legs. At times, there may be subtle movements. The child’s arms are usually flung out, while the body bends and knees are pulled up. Such a pattern is also referred to as jack-knife seizures. The spasms may involve the contraction of flexor muscles or extensor muscles.
Sometimes, both of these muscles may be involved in the spasms. The child may cry during the attack or after the spasm cluster is over. Lack of responsiveness, decreased mental alertness or loss of muscle control may also occur. A child could experience more than fifty spasm clusters in a day. A single spasm or a cluster that doesn’t consist of many spasms, may not be conspicuous. Symptoms of infantile spasms would, however, be noticeable, when a child experiences a spasm cluster wherein spasms occur at an interval of 5-15 seconds, for several minutes.
Diagnosis and Treatment of Infantile Spasms
A neurological examination is essential for diagnosing this medical condition. Diagnostic tests such as electroencephalogram (EEG), MRI and CT scan can certainly provide insights into the problems in the brain. An EEG can help the doctors analyze the electrical activity of the brain. Once the condition has been diagnosed, doctors may recommend the use of anti-epilepsy medication called vigabatrin.
Corticosteroids such as adrenocorticotropic hormone (ACTH), hydrocortisone, corticotropin or prednisolone may also be prescribed. Since mental retardation can also result from this epileptic condition, parents need to be extremely careful. Problems regarding developmental delay also need to be considered. As the child grows, following a ketogenic diet for epilepsy may also prove beneficial in lowering the incidence of such episodes.
Basically, the prognosis of infantile spasm as well as treatment options that may be recommended would depend on the underlying cause. In case of structural abnormality, surgery may be recommended. However, it may be performed only when doctors are certain that the removal of the tumor or growth wouldn’t cause any damage to the surrounding vital tissues. At times, this condition may resolve with the help of drug therapy and the spasms may stop.
This was a brief overview on infantile spasms. As mentioned earlier, in absence of medical treatment, epileptic seizures can affect the development of a child suffering from West’s syndrome. It is therefore, essential that parents consult a doctor, if they see signs of seizures in their child. The earlier it is diagnosed, the easier would it be to lower the incidence of seizures.