Neurophysiology of spasms

Spasms are a form of epileptic seizure typical of infancy. From a clinical point of view, the child presents a flexor–extensor movement involving the trunk and limbs and lasting about 1 s. Although asymmetry can be present, the seizure involves both sides of the body. The ictal discharge most freque...

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Bibliographic Details
Published in:Brain & development (Tokyo. 1979) 2001-11, Vol.23 (7), p.467-472
Main Authors: Vigevano, Federico, Fusco, Lucia, Pachatz, Christa
Format: Article
Language:English
Subjects:
Biological and medical sciences
Brain - physiopathology
Electrocardiography
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Humans
Ictal patterns
Infant
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Neurophysiology
Polygraphic studies
Spasms
Spasms, Infantile - diagnosis
Spasms, Infantile - physiopathology
Subcortical phenomenon
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Summary:Spasms are a form of epileptic seizure typical of infancy. From a clinical point of view, the child presents a flexor–extensor movement involving the trunk and limbs and lasting about 1 s. Although asymmetry can be present, the seizure involves both sides of the body. The ictal discharge most frequently associated with spasms in West syndrome (WS) is a diffuse triphasic slow high-amplitude wave and less frequently a low-amplitude brief rapid rhythm. The origin of the spasm in WS and classification as either partial or generalized seizure are the subject of much discussion. Factors supporting partial origin include: interictal electroencephalography (EEG) characterized by multifocal anomalies; high incidence of focal cortical lesions and remission of spasms following surgical removal of focal lesions. Factors supporting generalized origin are: clinical involvement of the entire body; mostly generalized ictal EEG pattern; existence of idiopathic cases and possibility of spasms immediately following a partial seizure like a particular form of secondary generalization. In our opinion, the categories of ‘partial’ and ‘generalized’ seizures are not applicable to spasms in WS. Sometimes the spasms in WS can be observed together with other types of partial or generalized seizures. Polygraphic recordings have demonstrated that despite being clinically similar, each spasm is different from the other because of a variable sequence in muscular contraction. These data support the peculiar nature of the spasm in WS that could be a subcortical phenomenon that requires a cortical trigger.
ISSN:0387-7604
1872-7131
DOI:10.1016/S0387-7604(01)00284-4