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...
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-03-01
|
| Series: | Heliyon |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S240584402301530X |
| _version_ | 1797851788280332288 |
|---|---|
| author | Christina Briscoe Abath Narayan Chandra Saha Seikh Azimul Hoque Ariful Islam Yamin Shahriar Chowdhury Mosammat Shameem Ara Begum Tahera Sultana Davalji Kanjiker Christopher J. Yuskaitis Chellamani Harini Md Badrul Alam Quazi Deen Mohammed Maitreyi Mazumdar |
| author_facet | Christina Briscoe Abath Narayan Chandra Saha Seikh Azimul Hoque Ariful Islam Yamin Shahriar Chowdhury Mosammat Shameem Ara Begum Tahera Sultana Davalji Kanjiker Christopher J. Yuskaitis Chellamani Harini Md Badrul Alam Quazi Deen Mohammed Maitreyi Mazumdar |
| author_sort | Christina Briscoe Abath |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-09T19:23:28Z |
| format | Article |
| id | doaj.art-7e719a43d8c54a39ad00eb70de9118ba |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-04-09T19:23:28Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-7e719a43d8c54a39ad00eb70de9118ba2023-04-05T08:23:57ZengElsevierHeliyon2405-84402023-03-0193e14323Clinical characteristics of children with infantile epileptic spasms syndrome from a tertiary-care hospital in Dhaka, BangladeshChristina Briscoe Abath0Narayan Chandra Saha1Seikh Azimul Hoque2Ariful Islam3Yamin Shahriar Chowdhury4Mosammat Shameem Ara Begum5Tahera Sultana Davalji Kanjiker6Christopher J. Yuskaitis7Chellamani Harini8Md Badrul Alam9Quazi Deen Mohammed10Maitreyi Mazumdar11Department of Neurology, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, USADepartment of Pediatric Neurology, National Institute of Neurosciences & Hospital, Sher-E-Bangla Nagar, Agargaon, Dhaka, 1207, BangladeshDepartment of Pediatric Neurology, National Institute of Neurosciences & Hospital, Sher-E-Bangla Nagar, Agargaon, Dhaka, 1207, BangladeshDepartment of Pediatric Neurology, National Institute of Neurosciences & Hospital, Sher-E-Bangla Nagar, Agargaon, Dhaka, 1207, BangladeshDepartment of Pediatric Neurology, National Institute of Neurosciences & Hospital, Sher-E-Bangla Nagar, Agargaon, Dhaka, 1207, BangladeshDepartment of Pediatric Neurology, National Institute of Neurosciences & Hospital, Sher-E-Bangla Nagar, Agargaon, Dhaka, 1207, BangladeshDepartment of Neurology, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, USADepartment of Neurology, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, USADepartment of Neurology, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, USADepartment of Pediatric Neurology, National Institute of Neurosciences & Hospital, Sher-E-Bangla Nagar, Agargaon, Dhaka, 1207, BangladeshDepartment of Pediatric Neurology, National Institute of Neurosciences & Hospital, Sher-E-Bangla Nagar, Agargaon, Dhaka, 1207, BangladeshDepartment of Pediatric Neurology, National Institute of Neurosciences & Hospital, Sher-E-Bangla Nagar, Agargaon, Dhaka, 1207, Bangladesh; Corresponding author.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.http://www.sciencedirect.com/science/article/pii/S240584402301530XInfantile spasmsACTHBangladesh |
| spellingShingle | Christina Briscoe Abath Narayan Chandra Saha Seikh Azimul Hoque Ariful Islam Yamin Shahriar Chowdhury Mosammat Shameem Ara Begum Tahera Sultana Davalji Kanjiker Christopher J. Yuskaitis Chellamani Harini Md Badrul Alam Quazi Deen Mohammed Maitreyi Mazumdar Clinical characteristics of children with infantile epileptic spasms syndrome from a tertiary-care hospital in Dhaka, Bangladesh Heliyon Infantile spasms ACTH 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 | Infantile spasms ACTH Bangladesh |
| url | http://www.sciencedirect.com/science/article/pii/S240584402301530X |
| work_keys_str_mv | AT christinabriscoeabath clinicalcharacteristicsofchildrenwithinfantileepilepticspasmssyndromefromatertiarycarehospitalindhakabangladesh AT narayanchandrasaha clinicalcharacteristicsofchildrenwithinfantileepilepticspasmssyndromefromatertiarycarehospitalindhakabangladesh AT seikhazimulhoque clinicalcharacteristicsofchildrenwithinfantileepilepticspasmssyndromefromatertiarycarehospitalindhakabangladesh AT arifulislam clinicalcharacteristicsofchildrenwithinfantileepilepticspasmssyndromefromatertiarycarehospitalindhakabangladesh AT yaminshahriarchowdhury clinicalcharacteristicsofchildrenwithinfantileepilepticspasmssyndromefromatertiarycarehospitalindhakabangladesh AT mosammatshameemarabegum clinicalcharacteristicsofchildrenwithinfantileepilepticspasmssyndromefromatertiarycarehospitalindhakabangladesh AT taherasultanadavaljikanjiker clinicalcharacteristicsofchildrenwithinfantileepilepticspasmssyndromefromatertiarycarehospitalindhakabangladesh AT christopherjyuskaitis clinicalcharacteristicsofchildrenwithinfantileepilepticspasmssyndromefromatertiarycarehospitalindhakabangladesh AT chellamaniharini clinicalcharacteristicsofchildrenwithinfantileepilepticspasmssyndromefromatertiarycarehospitalindhakabangladesh AT mdbadrulalam clinicalcharacteristicsofchildrenwithinfantileepilepticspasmssyndromefromatertiarycarehospitalindhakabangladesh AT quazideenmohammed clinicalcharacteristicsofchildrenwithinfantileepilepticspasmssyndromefromatertiarycarehospitalindhakabangladesh AT maitreyimazumdar clinicalcharacteristicsofchildrenwithinfantileepilepticspasmssyndromefromatertiarycarehospitalindhakabangladesh |