Glaze D G, Hrachovy R A, Frost J D, Kellaway P, Zion T E
Department of Neurology, Baylor College of Medicine, Houston, TX.
J Pediatr. 1988 Mar;112(3):389-96. doi: 10.1016/s0022-3476(88)80318-4.
We report the long-term outcome of 64 infants with infantile spasms, followed prospectively, using controlled treatment schedules and objective techniques (24-hour EEG and video monitoring) to determine response. Average age at follow-up was 50 months. Of the 64 infants, three (5%) died; of the others, 41 (67%) had developmental retardation of 50% or more or an IQ of 50 or less. Eight patients (13%) composed our cryptogenic study group and were so classified on the basis of normal CT scan, normal development prior to onset of infantile spasms, and undetermined cause. These patients had the better outcome; 38% had normal development or were only mildly retarded. Both the responders and nonresponders in our symptomatic group had a poor outcome; only 5% had normal development or mild impairment. Outcome was not significantly influenced by short versus long treatment lag or by response to therapy. Other types of seizures occurred in 34 patients (53%). In summary, the overall prognosis for long-term outcome in these 64 patients with infantile spasms was poor.
我们报告了64例婴儿痉挛症患儿的长期预后情况，这些患儿均接受前瞻性随访，采用对照治疗方案和客观技术（24小时脑电图和视频监测）来确定治疗反应。随访时的平均年龄为50个月。64例患儿中，3例（5%）死亡；其余患儿中，41例（67%）存在50%或更高程度的发育迟缓或智商低于50。8例患者（13%）组成了我们的隐源性研究组，他们是根据CT扫描正常、婴儿痉挛症发作前发育正常且病因不明而被如此分类的。这些患者的预后较好；38%发育正常或仅有轻度发育迟缓。我们症状性组中的反应者和无反应者预后均较差；只有5%发育正常或有轻度损伤。治疗延迟的长短或对治疗的反应对预后没有显著影响。34例患者（53%）出现了其他类型的癫痫发作。总之，这64例婴儿痉挛症患儿的长期总体预后较差。
