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With the modern noninvasive brain imaging methods, cerebral lesions of different types
and degrees can frequently be determined in infants with West syndrome. In CT examinations
preceding the spasms and the ACTH therapy, “idiopathic” forms of infantile spasms
were rare. The CT findings consistent with perinatal or postnatal encephalopathy were
more frequent than those found with embryonic or fetal lesions alone. The fact that
pathognomonic changes cannot be determined, may reflect the low specificity of CT
diagnosis in infants with chronic CNS diseases. A slight and mostly transient enlargement
of CSF spaces during ACTH therapy is a probable side-effect of the medication. In
infants with persistent or progressive enlargement of the CSF spaces, however, this
alteration appears to be mainly due to pre-existing brain damage. CT examinations
of infants with West syndrome should be performed because prognostic information may
be obtained and in a few cases operations to drain CSF may be necessary.
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© 1987 Published by Elsevier Inc.
