Child Neurology Society's Brainstorm CNS Brainstorm Episode 8 "Infantile Spasms" with guest Dr. John Mytinger
Mar 5, 2025
Dr. John Mytinger, an assistant professor at Ohio State University, breaks down the complexities of infantile spasms. He discusses the importance of early diagnosis and treatment, specifically how hypsarrhythmia is pivotal in identifying these spasms. The conversation delves into management strategies, emphasizing the effectiveness of traditional therapies like ACTH and the potential of the ketogenic diet. Dr. Mytinger also highlights advancements from the EPISTOP trial, showing that early intervention can significantly impact developmental outcomes.
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Defining Infantile Spasms
- Infantile spasms refer to epileptic spasms occurring mainly between 2 months and 2 years of age.
- They most commonly present in the first year, peaking around six months, and are often part of West syndrome.
Hypsarrhythmia Not Always Present
- Hypsarrhythmia is a chaotic EEG pattern seen in about 60% of infantile spasms cases.
- Its presence is not essential for diagnosis or linked to treatment response, prompting a broader syndrome definition.
Causes and Impact of Infantile Spasms
- Hundreds of diverse brain etiologies lead to infantile spasms by impairing development and triggering epileptic encephalopathy.
- Without swift treatment, spasms exacerbate developmental outcomes beyond the original pathology.