Corporate Advisory Board
Infantile spasms (IS) is a rare seizure disorder that occurs in young children, usually under one year of age. The average age of onset is around four months, but some children may experience spasms as early as one month. A few children may begin as late as two years. Only about 2,500 children in the US are diagnosed each year with IS. It often has a very subtle appearance so it is difficult for parents to recognize that it is a serious problem. When most people think of a seizure disorder, they may think of someone falling to the ground and having all-over body convulsions. It is very obvious when that happens that there is something wrong. Many people seeing a seizure for the first time are quite scared; while others may think that the person is going to die.
A young child having infantile spasms, on the other hand, may just have little head drops that do not appear to be anything serious. However, it is a much more serious seizure disorder than the generalized convulsion. Not only is it difficult for the parent to realize that this is a seizure disorder, it is also challenging for pediatricians. Infantile spasms are so uncommon that most pediatricians will see only one or two IS cases during all the years of practice. Also IS often looks similar to common disorders such as a normal startle reflex, colic, or reflux. It is very important to recognize that a child has IS as soon as it begins because:
there are medications that may control the spasms
the longer the spasms last before they are treated and controlled, the poorer the child may do developmentally
Unfortunately, children who develop IS are at great risk for developmental disability and autism, but some children will do well if they are treated early. Because the spells may be subtle, the diagnosis may be delayed for weeks or months
WHAT DO INFANTILE SPASMS LOOK LIKE?
Infantile spasms were first described by the English physician, Dr. W.J. West in 1841. His description is as accurate today as it was then. It is a remarkable report because Dr. West was describing his own son and he was asking for help. The following is a quote from Dr. West’s report describing his son:
“The child is now a year old; it was a remarkably fine, healthy child when born, and continued to thrive until he was four months old. It was at this time that I first observed slight bobbings of the head forward, which I then regarded as a trick, but were, in fact, the first indications of disease;
Like Dr. West’s son, many children with IS appear to be normal until the spasms begin. It seems that he was not concerned when he first saw the spasms because they did not appear to be serious. Just like Dr. West, parents today often tell us that they were not concerned at first. But, as the spasms become more obvious they realize that this is something serious.
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