WEST SYNDROME REVISITED

Abstract

West syndrome is an epileptic syndrome, characterized by a triad of symptoms: infantile spasms, hypsarrhythmia on interictal EEG, and a regression or delay of psycho-motoric development. According to the current concept, two of these three criteria suffice for the diagnosis. The incidence of this syndrome is 1 per 2000 newborns. This article reviews recent publications on the etiology, pathogenesis, clinical course, diagnosis, and treatment options in West syndrome. The text is supplemented with illustrations of ictal EEG at infantile spasms and variants of hypsarrhythmia. Today, in addition to classical hypsarrhythmia, five versions of modified hypsarrhythmia are proposed: synchronized version, asymmetric version, version with stable focus of spikes or acute waves, version with rhythmic flattening episodes, version with high-amplitude and asynchronous slow activity. The hormonal therapy is recommended to begin the treatment; if not effective, vigabatrin is to be used as the second choice medication.

Keywords

• epilepsy
• west syndrome
• infantile spasms
• ictal eeg
• interictal eeg
• modified hypsarrhythmia
• treatment.