Abstract
Spasms are a form of epileptic seizure typical of infancy. From a clinical point of
view, the child presents a flexor–extensor movement involving the trunk and limbs
and lasting about 1 s. Although asymmetry can be present, the seizure involves both sides of the body.
The ictal discharge most frequently associated with spasms in West syndrome (WS) is
a diffuse triphasic slow high-amplitude wave and less frequently a low-amplitude brief
rapid rhythm. The origin of the spasm in WS and classification as either partial or
generalized seizure are the subject of much discussion.
Factors supporting partial origin include: interictal electroencephalography (EEG)
characterized by multifocal anomalies; high incidence of focal cortical lesions and
remission of spasms following surgical removal of focal lesions. Factors supporting
generalized origin are: clinical involvement of the entire body; mostly generalized
ictal EEG pattern; existence of idiopathic cases and possibility of spasms immediately
following a partial seizure like a particular form of secondary generalization. In
our opinion, the categories of ‘partial’ and ‘generalized’ seizures are not applicable
to spasms in WS. Sometimes the spasms in WS can be observed together with other types
of partial or generalized seizures.
Polygraphic recordings have demonstrated that despite being clinically similar, each
spasm is different from the other because of a variable sequence in muscular contraction.
These data support the peculiar nature of the spasm in WS that could be a subcortical
phenomenon that requires a cortical trigger.
Keywords
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Article info
Publication history
Accepted:
August 15,
2001
Received in revised form:
August 12,
2001
Received:
August 9,
2001
Identification
Copyright
© 2001 Elsevier Science B.V. Published by Elsevier Inc. All rights reserved.
