Abstract
Aim: To provide information on the current status of West syndrome (WS) in the Philippines.
Methods: This is a retrospective review of WS cases from January 1997 to December
1999 from two largest referral government institutions. A questionnaire interview
survey on anticonvulsant usage was also conducted among practicing child neurologists.
Results: Twelve patients diagnosed to have infantile spasms at 2–15 months were included,
with a male:female ratio of 1:1. The proportion of WS cases among epileptic children
under age 3 was 3.18%. The etiologies were idiopathic/cryptogenic in four (33%) and
symptomatic in eight (66%). Symptomatic cases include hypoxic-ischemic encephalopathy,
neonatal sepsis, bacterial meningitis, inborn error of metabolism, congenital brain
anomaly and intracranial hemorrhage. Phenobarbital was the first line drug in 75%
of cases. Other drugs used were valproic acid, clonazepam and pyridoxine. With a follow-up
duration of 1–40 months, only three patients became seizure free and most had poor
neurodevelopmental outcome. Among practicing child neurologists, the preferred ideal
drug was adrenocorticotrophic hormone (ACTH) and valproic acid for idiopathic and
symptomatic cases, respectively. However, in actual clinical practice valproic acid
or prednisone was the initial drug used. Pyridoxine was usually added on.
Conclusions: The proportion of WS in our patient population may not reflect the true
prevalence in our country since our data came from a biased population, i.e. referral
centers. A national statistics is currently not available. ACTH, which was perceived
by most child neurologists as the ideal first line drug was not used primarily because
it is unavailable and unaffordable. The poor seizure control and developmental outcome
may be due to the treatment given or directly related to the etiology of WS.
Keywords
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Article info
Publication history
Accepted:
June 4,
2001
Received in revised form:
June 1,
2001
Received:
March 16,
2001
Identification
Copyright
© 2001 Published by Elsevier Inc.
