Abstract
To clarify the characteristics of the mode of appearance and morphology of epileptiform
discharges before the onset of West syndrome (WS). The subjects were 25 infants whose
electroencephalograms (EEGs) were recorded before the onset of WS and whose first
EEG was recorded before 6 months of corrected age (CA). We extensively analyzed the
chronological and topographical changes of the epileptiform discharges before the
onset of WS. The location of the initial epileptiform discharges was in the posterior
areas in 14 (Group O), the multiple areas in 7 (Group M), and areas other than occipital
in 4 (Group non-O). Twelve of the 14 patients in Group O were premature infants, and
all but one had PVL. Most patients in Group M were full-term infants or near full-term
infants who had hypoxic damage. The ages at the appearance of the initial epileptiform
discharges in Group O were significantly later than those in Group M: 3.0–5.9 months
of CA in Group O vs. −0.1 to 2.0 months of CA in Group M. These facts suggest that
the difference of brain damage is related to both the topographical characteristics
and the age at the appearance of initial epileptiform discharges, and around 3 months
of CA is a critical period for the appearance of occipital hyperexcitability. Hypsarrhythmia
and tonic spasms appeared almost simultaneously from 4 to 6 months of CA in most patients.
To predict the occurrence of WS in high-risk infants, EEG follow-ups from early infancy
are very useful.
Keywords
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Article info
Publication history
Accepted:
April 18,
2007
Received in revised form:
March 23,
2007
Received:
October 25,
2006
Identification
Copyright
© 2007 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
