Emergency: requires immediate attention
Infantile spasms
Alerts and Notices
Synopsis
The seizures are characterized by sudden, typically bilateral, spasms of the neck, trunk, and/or extremities with associated brief loss of consciousness. Spasms can be flexor, extensor, or mixed. Most seizures last seconds and occur in clusters with up to hundreds of spasms in a day.
Infantile spasms can be associated with many neurologic conditions including tuberous sclerosis, neuronal migration disorders, hypoxic-ischemic injury, cerebral palsy, or Down syndrome. Up to one-third of cases have no obvious underlying abnormality. Prognosis is typically poor (although somewhat better in the cryptogenic group); while spasms usually remit by age 3, most children go on to develop other seizure types, with up to 50% developing Lennox-Gastaut syndrome. Developmental delay and cognitive impairment is common.
Codes
ICD10CM:G40.822 – Epileptic spasms, not intractable, without status epilepticus
SNOMEDCT:
28055006 – West syndrome
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Colic
- Gastroesophageal reflux disease
- Exaggerated Moro reflex or exaggerated startle
- Stereotypies
- Benign neonatal sleep myoclonus
- Benign myoclonus of early infancy
- Tonic reflex seizures of early infancy
- Myoclonic epilepsies (see juvenile myoclonic epilepsy)
Best Tests
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Management Pearls
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Therapy
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References
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Last Reviewed:05/21/2017
Last Updated:06/19/2022
Last Updated:06/19/2022