Outcomes of West syndrome: literature review and own data

Abstract

The article is devoted to the treatment and prediction of outcomes of West syndrome. The analysis of literary and own data was carried out. Was estimated the effectiveness of treatment and predicted the outcomes of the disease by data of anamnesis, seizures and the possibilities of therapy. The article presents a stepwise scheme for the treatment of West syndrome and evaluates the results of the application of various drugs, including valproic acid, vigabatrin*, levetiracetam, phenobarbital, clonazepam and topiramate. Special attention is paid to the role of hormone therapy, demonstrated its high efficiency. The most significant prognostic criteria for the outcome of this disease are identified. These criteria are based on literature and our own data. Predictors of an adverse outcome of West syndrome include: symptomatic forms of disease (structural, genetic, infectious), impaired neuropsychological development before onset of epileptic spasms, age of spasms onset more than 8 months, the presence of other seizures types in addition to epileptic spasms, the need for polytherapy of antiepileptic drugs. The pathology of pregnancy, the period of adaptation, neonatal seizures, starting therapy and the response to it are not always important in predicting remission.