Neurodevelopmental outcomes of the West syndrome in pediatric patients: The first report from the Middle-East

• Published in: Research in developmental disabilities 2019-06, Vol.89, p.114-119
• Main Authors: Nasiri, Jafar, Kachuei, Maryam, Kermani, Rasool, Samaninobandegani, Zahra
• Format: Article
• Language: English
• Subjects: Child Development; Child, Preschool; Cognition; Developmental Disabilities - diagnosis; Developmental Disabilities - epidemiology; Developmental Disabilities - etiology; Developmental outcome; Female; Humans; Infant; Iran - epidemiology; Language Development; Male; Motor Skills; Neuropsychological Tests; Nfantile; Outcome Assessment, Health Care; Spasm; Spasms, Infantile - diagnosis; Spasms, Infantile - epidemiology; Spasms, Infantile - physiopathology; Spasms, Infantile - psychology; West syndrome
• ISSN: 0891-4222; 1873-3379
• DOI: 10.1016/j.ridd.2019.03.010

This study aimed to investigate the clinical characteristics and neurodevelopmental outcomes of children with West syndrome (WS) by using the Bayley-III scale of infant development, as the first report from the Middle-East. Between January 2013 and February 2016, we prospectively enrolled 67 consecutive patients with a confirmed diagnosis of WS from Isfahan, Iran. Cognition, language and motor outcomes of the studied subjects were evaluated with the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III). Overall, 67 cases, including 34 (50.7%) boys and 33 (49.3%) girls (a male/female ratio of 1.03), were enrolled for the study. The mean age was 26.7 ± 12.9 months. Among the subjects, 50 (74.6%) patients had symptomatic WS, and 17 (25.4%) patients had cryptogenic WS. “Severe delay” was found in 76.9% of the patients regarding cognitive evaluation, 67.7% for language and communication abilities, and, 81.5% for motor function. The patients with cryptogenic WS were significantly more likely to have more favorable outcomes in motor (p = 0.035), cognitive (p = 0.035) and receptive language (p = 0.043) in comparison to those who had symptomatic WS. The patients with controlled seizures were significantly more likely to have more favorable outcomes in motor (p = 0.027) and cognition (p = 0.011) as compared to those with uncontrolled seizures. WS was associated with poor neurodevelopmental outcome in our study. Severe developmental delay was associated with two major factors: (i) presence of a specific underlying abnormality (symptomatic WS) and(ii) persistent seizures as a result of the former.