Clinical Profile and Treatment Outcome of Infantile Spasms Of varied etiology: A Hospital-Based Observational Study

Abstract

Objective: To evaluate the clinical profile, neuroimaging and electroencephalographic findings, and outcomes among children diagnosed with infantile spasms.
Methods: This prospective observational hospital-based study was conducted in the Department of Pediatrics, S.C.B. Medical College and Hospital and SVPPGIP, Cuttack, Odisha, from August 2023 to July 2025. Fifty children clinically diagnosed with infantile spasms and/or confirmed with electroencephalography (EEG) findings were included. Demographic details, perinatal history, developmental status, EEG and magnetic resonance imaging (MRI) findings, type of spasms, and treatment response to adrenocorticotropic hormone (ACTH) were analyzed.
Results: Among the 50 children enrolled, 26 (52%) were females and 24 (48%) were males. Majority of children (94%) belonged to the age group of 6 months to 2 years. History suggestive of birth asphyxia was present in 80% of cases. Developmental delay was observed in 76% of children. Flexor spasms were the most common type (62%), followed by mixed spasms (22%) and extensor spasms (16%). EEG abnormalities were noted in 48% and MRI abnormalities in 42% of children. Complete seizure control with ACTH therapy was achieved in all children with extensor spasms, 74.2% of children with flexor spasms, and 54.5% of children with mixed spasms. A statistically significant association was observed between developmental outcome after follow-up and type of spasm (p=0.043).
Conclusion: Infantile spasms commonly present between 6 months and 2 years of age and are frequently associated with birth asphyxia and developmental delay. Flexor spasms were the predominant presentation. ACTH therapy achieved favorable seizure control, particularly in children with extensor and flexor spasms. Early recognition and prompt treatment may improve both seizure and developmental outcomes.