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Predicting risk for infantile spasms after acute symptomatic neonatal seizures

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Infantile spasms (IS) is a severe epilepsy in early childhood. Early treatment of IS provides the best chance of seizure remission and favorable developmental outcome.

Taeun Chang, M.D., director of the Neonatal Neurology and Neurocritical Care Program at Children’s National Hospital, participated in a study with other national pediatric experts which aimed to develop a prediction rule to accurately predict which neonates with acute symptomatic seizures will develop IS.

The group of researchers found that multiple potential predictors were associated with IS, including Apgar scores, EEG features, seizure characteristics, MRI abnormalities and clinical status at hospital discharge. The final model born from this work included three risk factors: (a) severely abnormal EEG or ≥3 days with seizures recorded on EEG, (b) deep gray or brainstem injury on MRI and (c) abnormal tone on discharge exam.

The significance of these findings is that IS risk after acute symptomatic neonatal seizures can be stratified using commonly available clinical data. No child without risk factors, vs >50% of those with all three factors, developed IS. This risk prediction rule may be valuable for clinical counseling as well as for selecting participants for clinical trials to prevent post‐neonatal epilepsy. This tailored approach may lead to earlier diagnosis and treatment and improve outcomes for a devastating early life epilepsy.

Read the full study in Epilepsia.