Seki T, Kawahara Y, Hirose M
Folia Psychiatr Neurol Jpn. 1976;30(3):297-306. doi: 10.1111/j.1440-1819.1976.tb02266.x.
A follow-up study has been made of 25 cases with infantile spasms, all of whom were six years old or more at review. Only four (16%) out of 25 cases made a full recovery and attended normal school. Spasms ceased in 96% of all cases, but fits other than spasms (grand mal, tonic seizure, atonic seizure, myoclonic seizure, atypical absence and psychomotor seizure) occurred subsequently in 11 cases (44%). The EEG became normal in two cases (8%), but still showed modified hypsarhythmia in three cases (12%), "epileptic non-hypsarhythmic" discharges in 17 cases (68%) and non-specific abnormalities in three cases (12%). The important factors associated with good prognosis were normal development before the onset of spasms, late onset (seven months old or over) and short duration of spasms, the absence of other types of fit following spasms and lack of neurological abnormality. A bad prognosis was associated with abnormal development prior to the onset of spasms, early onset and long duration of spasms, the presence of other types of fit following spasms and evidence of any neyrological abnormality This follow-up may confirm that the therapy with ACTH-A has no significant effect on final mental state.
对25例婴儿痉挛症患者进行了一项随访研究，所有患者在复查时均已满6岁。25例患者中只有4例（16%）完全康复并进入正常学校就读。所有病例中有96%的痉挛停止，但随后有11例（44%）出现了除痉挛以外的发作类型（大发作、强直发作、失张力发作、肌阵挛发作、非典型失神发作和精神运动性发作）。脑电图有2例（8%）恢复正常，但仍有3例（12%）显示改良高度节律失调，17例（68%）显示“癫痫非高度节律失调”放电，3例（12%）显示非特异性异常。与预后良好相关的重要因素是痉挛发作前发育正常、发病较晚（7个月及以上）、痉挛持续时间短、痉挛后无其他发作类型以及无神经学异常。预后不良与痉挛发作前发育异常、发病早、痉挛持续时间长、痉挛后存在其他发作类型以及任何神经学异常证据有关。此次随访可能证实促肾上腺皮质激素A疗法对最终精神状态无显著影响。
