Abstract
Recent advances in diagnostic and therapeutic techniques may have changed incidence
and etiologies of West syndrome (WS). We performed a retrospective epidemiological
study of WS that occurred in 47 children in Nagasaki Prefecture during a recent 10-year
period from 1989 to 1998. The incidence of WS was 3.1/10,000 live births. Thirty-nine
patients (83%) had symptomatic WS, in which the prenatal causes were most frequent,
followed by low-birth weight (LBW) infants, perinatal and postnatal. Such high frequency
of LBW may have been due to a relative increase in survivors of premature babies because
of recent advances in perinatal care. The brain computerized tomography/magnetic resonance
imaging performed in 41 patients revealed congenital brain malformation (10 patients),
destructive brain disorders (13 patients), and no structural abnormalities (18 patients).
The seizure outcome was worse in the symptomatic WS than in the cryptogenic WS. The
developmental outcome was very poor in both symptomatic and cryptogenic WS. The mean
developmental quotient (DQ) in all patients was 25, and only four patients (11%) had
a normal DQ (>70). DQ was lower in patients with developmental delay before the onset
of WS, symptomatic group, relapse and/or persistence of seizure. Developmental delay
seen in WS patients seems to be related to the two major factors, that is, underlying
brain abnormalities and the persistent seizures as a result of the former. Therefore,
every effort should be made to control seizures, including medical and early surgical
treatment, as well as prevention of brain damage through perinatal care.
Keywords
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Article info
Publication history
Accepted:
July 14,
2001
Received in revised form:
July 11,
2001
Received:
June 11,
2001
Identification
Copyright
© 2001 Elsevier Science B.V. Published by Elsevier Inc. All rights reserved.
