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Clinical characteristics of children with infantile epileptic spasms syndrome from a tertiary-care hospital in Dhaka, Bangladesh

BACKGROUND: We describe patient characteristics and response to initial treatment in a large case series of children presenting with infantile epileptic spasms syndrome to a tertiary-care hospital with a pediatric neurology service in Bangladesh. The purpose of the study was to add to the growing bo...

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Autores principales: Abath, Christina Briscoe, Chandra Saha, Narayan, Hoque, Seikh Azimul, Islam, Ariful, Chowdhury, Yamin Shahriar, Ara Begum, Mosammat Shameem, Davalji Kanjiker, Tahera Sultana, Yuskaitis, Christopher J., Harini, Chellamani, Alam, Md Badrul, Mohammed, Quazi Deen, Mazumdar, Maitreyi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10025103/
https://www.ncbi.nlm.nih.gov/pubmed/36950644
http://dx.doi.org/10.1016/j.heliyon.2023.e14323
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author Abath, Christina Briscoe
Chandra Saha, Narayan
Hoque, Seikh Azimul
Islam, Ariful
Chowdhury, Yamin Shahriar
Ara Begum, Mosammat Shameem
Davalji Kanjiker, Tahera Sultana
Yuskaitis, Christopher J.
Harini, Chellamani
Alam, Md Badrul
Mohammed, Quazi Deen
Mazumdar, Maitreyi
author_facet Abath, Christina Briscoe
Chandra Saha, Narayan
Hoque, Seikh Azimul
Islam, Ariful
Chowdhury, Yamin Shahriar
Ara Begum, Mosammat Shameem
Davalji Kanjiker, Tahera Sultana
Yuskaitis, Christopher J.
Harini, Chellamani
Alam, Md Badrul
Mohammed, Quazi Deen
Mazumdar, Maitreyi
author_sort Abath, Christina Briscoe
collection PubMed
description BACKGROUND: We describe patient characteristics and response to initial treatment in a large case series of children presenting with infantile epileptic spasms syndrome to a tertiary-care hospital with a pediatric neurology service in Bangladesh. The purpose of the study was to add to the growing body of literature on infantile epileptic spasms syndrome in low- and middle-income countries. METHODS: We enrolled 212 infants with new-onset infantile epileptic spasms syndrome (IESS) at the time of initial presentation to the National Institute of Neurosciences and Hospital (NINS) in Dhaka, Bangladesh, between January 2019 and August 2021. We collected data about seizure type and frequency, etiology, medication dosage, and available neuroimaging. RESULTS: Median age at initial presentation to NINS was 9 months. Developmental delay and regression prior to presentation were found in 83% and 36%, respectively. Prior to their presentation at NINS, 197 (93%) patients had received anti-seizure medication to treat spasms, of whom only 8 (4%) had received standard therapy with ACTH, prednisolone, or vigabatrin. At NINS, 207 (98%) of patients received standard therapy, most frequently ACTH in 154 (73%). Median time between seizure onset to receipt of first-line therapy was 5 months. Of the 169 patients who were seen in follow-up at average of 5 weeks, 92 (54%) reported absence of clinical epileptic spasms. No serious adverse events requiring hospitalization were reported. CONCLUSIONS: This study highlights the long lead times to treatment for IESS in a low- and middle-income country, and the need for early referral of children with suspected epileptic spasms to epilepsy care centers.
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spelling pubmed-100251032023-03-21 Clinical characteristics of children with infantile epileptic spasms syndrome from a tertiary-care hospital in Dhaka, Bangladesh Abath, Christina Briscoe Chandra Saha, Narayan Hoque, Seikh Azimul Islam, Ariful Chowdhury, Yamin Shahriar Ara Begum, Mosammat Shameem Davalji Kanjiker, Tahera Sultana Yuskaitis, Christopher J. Harini, Chellamani Alam, Md Badrul Mohammed, Quazi Deen Mazumdar, Maitreyi Heliyon Research Article BACKGROUND: We describe patient characteristics and response to initial treatment in a large case series of children presenting with infantile epileptic spasms syndrome to a tertiary-care hospital with a pediatric neurology service in Bangladesh. The purpose of the study was to add to the growing body of literature on infantile epileptic spasms syndrome in low- and middle-income countries. METHODS: We enrolled 212 infants with new-onset infantile epileptic spasms syndrome (IESS) at the time of initial presentation to the National Institute of Neurosciences and Hospital (NINS) in Dhaka, Bangladesh, between January 2019 and August 2021. We collected data about seizure type and frequency, etiology, medication dosage, and available neuroimaging. RESULTS: Median age at initial presentation to NINS was 9 months. Developmental delay and regression prior to presentation were found in 83% and 36%, respectively. Prior to their presentation at NINS, 197 (93%) patients had received anti-seizure medication to treat spasms, of whom only 8 (4%) had received standard therapy with ACTH, prednisolone, or vigabatrin. At NINS, 207 (98%) of patients received standard therapy, most frequently ACTH in 154 (73%). Median time between seizure onset to receipt of first-line therapy was 5 months. Of the 169 patients who were seen in follow-up at average of 5 weeks, 92 (54%) reported absence of clinical epileptic spasms. No serious adverse events requiring hospitalization were reported. CONCLUSIONS: This study highlights the long lead times to treatment for IESS in a low- and middle-income country, and the need for early referral of children with suspected epileptic spasms to epilepsy care centers. Elsevier 2023-03-05 /pmc/articles/PMC10025103/ /pubmed/36950644 http://dx.doi.org/10.1016/j.heliyon.2023.e14323 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Article
Abath, Christina Briscoe
Chandra Saha, Narayan
Hoque, Seikh Azimul
Islam, Ariful
Chowdhury, Yamin Shahriar
Ara Begum, Mosammat Shameem
Davalji Kanjiker, Tahera Sultana
Yuskaitis, Christopher J.
Harini, Chellamani
Alam, Md Badrul
Mohammed, Quazi Deen
Mazumdar, Maitreyi
Clinical characteristics of children with infantile epileptic spasms syndrome from a tertiary-care hospital in Dhaka, Bangladesh
title Clinical characteristics of children with infantile epileptic spasms syndrome from a tertiary-care hospital in Dhaka, Bangladesh
title_full Clinical characteristics of children with infantile epileptic spasms syndrome from a tertiary-care hospital in Dhaka, Bangladesh
title_fullStr Clinical characteristics of children with infantile epileptic spasms syndrome from a tertiary-care hospital in Dhaka, Bangladesh
title_full_unstemmed Clinical characteristics of children with infantile epileptic spasms syndrome from a tertiary-care hospital in Dhaka, Bangladesh
title_short Clinical characteristics of children with infantile epileptic spasms syndrome from a tertiary-care hospital in Dhaka, Bangladesh
title_sort clinical characteristics of children with infantile epileptic spasms syndrome from a tertiary-care hospital in dhaka, bangladesh
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10025103/
https://www.ncbi.nlm.nih.gov/pubmed/36950644
http://dx.doi.org/10.1016/j.heliyon.2023.e14323
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