68:
819:
and there is a lower relapse rate. Children with this form of the syndrome are less likely to go on to develop other forms of epilepsy; around two in every five children develop at the same rate as healthy children. In other cases, however, treatment of West syndrome is relatively difficult and the results of therapy often dissatisfying; for children with symptomatic and cryptogenic West syndrome, the prognosis is generally not positive, especially when they prove resistant to therapy.
751:
375:
255:
144:
331:
following three groups: genetic, structural/metabolic, and unknown. The new terms are more immediately clear in their meaning, except that the structural and metabolic group includes cases that have a genetic component that does not always directly lead to the condition. Only the genetic grouping has a known direct genetic cause. "Unknown" cases may be of
850:(in around 3 out of 10 children). Once more, the cause of each individual case of West syndrome must be considered when debating cause and effect. As many as 6 out of 10 children with West syndrome have epilepsy later in life. Sometimes West syndrome turns into a focal or other generalised epilepsy. Around half of all children develop
862:
Incidence is around 1:3200 to 1:3500 of live births. Statistically, boys are more likely to be affected than girls at a ratio of around 3:2. In 9 out of every 10 children affected, the spasms appear for the first time between the third and the twelfth month of age. In rarer cases, spasms may occur in
736:
for treating infantile spams was inconsistent; most trials were as a second-line therapy after failure of drug treatment, and as of 2017 it had not been explored as a first line treatment in an adequately designed clinical trial. Epilepsy surgery is recommended in patients with seizures arising from
818:
The prognosis for children with idiopathic West syndrome are mostly more positive than for those with the cryptogenic or symptomatic forms. Idiopathic cases are less likely to show signs of developmental problems before the attacks begin, the attacks can often be treated more easily and effectively
236:: a flexor spasm with rapid bending of the head and torso forward and simultaneous raising and bending of the arms while partially drawing the hands together in front of the chest and/or flailing. If one imagined this act in slow motion, it would appear similar to the Muslim ceremonial greeting (
98:
in 1841. The original case actually described his own son, James Edwin West (1840–1860). Other names for it are "generalized flexion epilepsy", "infantile epileptic encephalopathy", "infantile myoclonic encephalopathy", "jackknife convulsions", "massive myoclonia" and "Salaam spasms". The term
822:
Statistically, 5 out of every 100 children with West syndrome do not survive beyond five years of age, in some cases due to the cause of the syndrome, in others for reasons related to their medication. Only less than half of all children can become entirely free from attacks with the help of
330:
Cases of epilepsy have been historically divided into three different groups: symptomatic, cryptogenic, and unknown. The
International League Against Epilepsy (ILAE) in 2011 recommended abandoning these terms for reasons of clarity and instead trying to place individual cases into one of the
204:
The epileptic seizures observed in infants with West syndrome, fall into three categories, collectively known as infantile spasms. Typically, the following triad of attack types appears; while the three types usually appear simultaneously, they also can occur independently of each other:
839:, even when treatment for the seizures is successful. This is not usually because of the epileptic seizures, but rather because of the causes behind them (cerebral anomalies or their location or degree of severity). Severe, frequent attacks can (further) damage the brain.
1343:
1328:
594:
records for children with Down syndrome are often more symmetrical with fewer unusual findings. Although not all children can become entirely free from attacks with medication, children with Down syndrome are less likely to go on to develop
439:
West syndrome, as the attacks manifest as a symptom of another problem. Almost any cause of brain damage could be associated, and these are divided into prenatal, perinatal, and post-natal. The following is a partial list:
99:"infantile spasms" can be used to describe the specific seizure manifestation in the syndrome, but is also used as a synonym for the syndrome itself. West syndrome in modern usage is the triad of infantile spasms, a
1050:
Goldberg-Stern et al., 2001 & Eisermann et al. 2003 in: American
Journal of Medical Genetics part C, 2006, S. 163: Neurobehavioral disorders in children, adolescents and young adults with down syndrome
113:
The syndrome is age-related, generally occurring between the third and the twelfth month, generally manifesting around the fifth month. There are various causes. The syndrome is often caused by an organic
879:. In 1841 he observed this type of epilepsy in his own son, James E West, who was approximately four months old at the time. He published his observations from a scientific perspective in an article in
631:, in which genetic and sometimes hereditary influences play a role. There are known cases in which West syndrome appears in successive generations in boys; this has to do with X-chromosomal heredity.
584:
abnormalities involved in Down syndrome. However, in children with Down syndrome, the syndrome is often far more mild, and the children often react better to medication. The
1453:
1068:
Sherr EH (2003) The ARX story (epilepsy, mental retardation, autism, and cerebral malformations): one gene leads to many phenotypes. Curr Opin
Pediatr 15(6):567-571
1078:
Gertler, T.; Bearden, D.; Bhattacharjee, A.; Carvill, G.; Adam, M. P.; Mirzaa, G. M.; Pagon, R. A.; Wallace, S. E.; Bean LJH; Gripp, K. W.; Amemiya, A. (1993).
327:(CRH). It is possible that more than one factor is involved. Both hypotheses are supported by the effect of certain medications used to treat West syndrome.
815:
for development due to the variability of causes, as mentioned above, the differing types of symptoms and cause. Each case must be considered individually.
842:
Permanent damage often associated with West syndrome in the literature include cognitive disabilities, learning difficulties and behavioural problems,
1738:
1821:
991:
714:
697:
patterns. According to
Infantile Spasms: Act Now, delays to diagnosis of more than 7 days increase life-long developmental impairment. In addition,
823:
medication. Statistics show that treatment produces a satisfactory result in around three out of ten cases, with only one in every 25 children's
729:
with long term use. The high cost of ACTH leads doctors to avoid it in the US; higher dose prednisone appears to generate equivalent outcomes.
926:
230:: Convulsions of the throat and neck flexor muscles, during which the chin is fitfully jerked towards the breast or the head is drawn inward.
1652:
510:
1785:
1446:
1358:
1059:
Bahi-Buisson N, Bienvenu T (2012) CDKL5-related disorders: from clinical description to molecular genetics. Mol
Syndromol 2(3-5):137-152
1715:
1800:
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1133:
798:
772:
422:
396:
302:
276:
191:
165:
1743:
1546:
892:
324:
315:
It is still unknown which bio-chemical mechanisms lead to the occurrence of West syndrome. It is known to be a malfunction of
1760:
1733:
1439:
776:
400:
280:
169:
1017:
1795:
1710:
550:
1677:
110:), and developmental regression – although the international definition requires only two out of these three elements.
1765:
640:
761:
647:) genes. The ARX gene in particular seems to be responsible for at least some of the X linked cases. Variants in the
606:
If, however, a child with Down syndrome has seizures that are difficult to control, the child should be assessed for
385:
265:
154:
1682:
639:
Mutations in several genes have been associated with West syndrome. These include the
Aristaless related homeobox (
618:
When a direct cause cannot be determined but the child has other neurological disorder, the case is referred to as
607:
444:
In around one third of the children, there is evidence of a profound organic disorder of the brain. This includes:
216:
convulsions of the entire body or several parts of the body in split seconds, and the legs in particular are bent (
780:
765:
627:
Sometimes multiple children within the same family develop West syndrome. In this case, it is also referred to as
521:
404:
389:
284:
269:
173:
158:
1833:
351:
this refers to a disorder whose cause is hidden or occult. Cryptogenic epilepsies are presumed to be symptomatic.
1629:
1369:
1882:
1594:
1559:
851:
831:
development developing more or less normally. A large proportion (up to 90%) of children experience severe
713:
As of 2017, data on optimal treatment was limited. Therapies with hormones is the standard of care, namely
596:
320:
221:
1887:
1609:
1589:
1529:
591:
505:
995:
588:
noted in 2003 that what was normally a serious epilepsy was in such cases often a relatively benign one.
1667:
1614:
624:
West syndrome. The cryptogenic group is often considered idiopathic while referred to as "cryptogenic".
725:, marketed under brands Vigpoder and Sabril, is also a common consideration, though there is a risk of
1850:
1644:
1634:
1554:
1505:
836:
67:
1838:
1805:
1347:
832:
664:
620:
1877:
1725:
1702:
1166:
872:
477:
452:
89:
345:
the epilepsy is the consequence of a known or suspected disorder of the central nervous system.
1790:
1619:
1462:
1380:
1289:
1264:
1215:
1158:
1087:
922:
916:
546:
237:
56:
1855:
1844:
1599:
1500:
1254:
1246:
1205:
1197:
1148:
955:
483:
457:
316:
1184:
Asano, E; Juhász, C; Shah, A; Muzik, O; Chugani, DC; Shah, J; Sood, S; Chugani, HT (2005).
1827:
1692:
1657:
1495:
1490:
1039:
562:
530:
671:
Regular development until the onset of the attacks or before the beginning of the therapy
599:
or other forms of epilepsy than those without additional hereditary material on the 21st
580:. This form of epilepsy is relatively difficult to treat in children who do not have the
323:
transmission process. Another possibility being researched is a hyper-production of the
1753:
1748:
1662:
1536:
1521:
1485:
1259:
1234:
1210:
1185:
843:
733:
694:
554:
515:
488:
107:
1352:
959:
1871:
1578:
1569:
1480:
1201:
912:
577:
462:
100:
1409:
1170:
828:
726:
675:
542:
536:
494:
473:
447:
1233:
Chugani, HT; Ilyas, M; Kumar, A; Juhász, C; Kupsky, WJ; Sood, S; Asano, E (2015).
1153:
84:
disorder in infants, children and adults. One of the other names of the disorder,
1425:
1374:
603:. The reason why it is easier to treat children with Down syndrome is not known.
1079:
750:
374:
254:
143:
1186:"Origin and propagation of epileptic spasms delineated on electrocorticography"
973:
1385:
1337:
880:
722:
718:
600:
581:
468:
94:
1018:"New concepts in classification of the epilepsies: Entering the 21st century"
693:
Diagnosis can be made by EEG. In case of epileptic spasms, EEG shows typical
357:
there is no underlying cause other than a possible hereditary predisposition.
17:
1404:
876:
824:
812:
213:
127:
123:
81:
61:
1268:
1219:
1162:
1091:
502:
Furthermore, other causes increasingly being named in the literature are:
1466:
119:
1431:
1320:
1235:"Surgical treatment for refractory epileptic spasms: The Detroit series"
1134:"Epileptic spasms - 175 years on: Trying to teach an old dog new tricks"
217:
1250:
1332:
847:
558:
943:
319:
function, or more precisely, a malfunction in the regulation of the
1105:
361:
The remainder of this section will refer to the older terminology.
1282:
Johnston, Michael V.; Adams, Harold P.; Fatemi, Ali (2016-08-18).
921:(4th ed.). Lippincott Williams & Wilkins. pp. 333–.
648:
644:
115:
863:
the first two months or during the second to fourth year of age.
1363:
846:(up to 5 out of 10 children), psychological disorders and often
717:(ACTH) sold under brand Acthar, or oral corticosteroids such as
1435:
585:
92:(1793–1848), who first described it in an article published in
744:
368:
248:
137:
103:
871:
West syndrome was named after the
English doctor and surgeon
663:
West syndrome, when a cause cannot be determined. Important
561:
or brain damage of various types as well as that caused by
435:
If a cause presents itself, the syndrome is referred to as
1132:
Wilmshurst JM, Ibekwe RC, O'Callaghan FJK (January 2017).
338:
The old terminology was defined by the ILAE as follows:
335:
genetic, structural, metabolic, or other unknown cause.
1040:
http://www.ilae.org/Visitors/Centre/ctf/CTFoverview.cfm
220:
muscle convulsions here are generally more severe than
1084:
KCNT1-Related
Epilepsy - GeneReviews® - NCBI Bookshelf
651:
gene can also in rare cases result in West syndrome.
1310:
1127:
1125:
1123:
1121:
1119:
918:
The
Treatment of Epilepsy: Principles & Practice
1814:
1778:
1724:
1701:
1643:
1577:
1568:
1545:
1514:
1473:
1395:
1314:
883:. He named the seizures "Salaam Tics" at the time.
240:), from which this type of attack derives its name.
55:
37:
32:
576:West syndrome appears in 1% to 5% of infants with
685:Those are becoming rare due to modern medicine.
1447:
944:"On a Peculiar Form of Infantile Convulsions"
8:
732:As of 2017 data from clinical trials of the
659:Occasionally the syndrome is referred to as
978:Whonamedit? A dictionary of medical eponyms
779:. Unsourced material may be challenged and
403:. Unsourced material may be challenged and
283:. Unsourced material may be challenged and
172:. Unsourced material may be challenged and
1574:
1454:
1440:
1432:
1311:
915:; Ajay Gupta; Deepak K. Lachhwani (2006).
66:
29:
1258:
1209:
1152:
992:"NINDS Infantile Spasms Information Page"
811:It is not possible to make a generalised
799:Learn how and when to remove this message
423:Learn how and when to remove this message
303:Learn how and when to remove this message
192:Learn how and when to remove this message
88:, is in memory of the English physician,
1822:Citizens United for Research in Epilepsy
1424:Much of this article is translated from
904:
681:no evidence of a trigger for the spasms
643:) and cyclin dependent kinase like 5 (
1106:"Infantile Spasms & West Syndrome"
1086:. University of Washington, Seattle.
549:(lack of oxygen, e.g. during birth),
7:
1739:Dentatorubral–pallidoluysian atrophy
777:adding citations to reliable sources
401:adding citations to reliable sources
281:adding citations to reliable sources
170:adding citations to reliable sources
1786:Sudden unexpected death in epilepsy
1716:Complex partial status epilepticus
1426:the German Knowledge (XXG) article
25:
1801:Psychogenic non-epileptic seizure
1673:Benign familial neonatal seizures
1625:Sleep-related hypermotor epilepsy
118:dysfunction whose origins may be
1202:10.1111/j.1528-1167.2005.05205.x
749:
586:German Down Syndrome Info Center
373:
253:
142:
893:Epilepsy Phenome/Genome Project
325:corticotropin-releasing hormone
1761:Early myoclonic encephalopathy
1734:Progressive myoclonus epilepsy
1:
1154:10.1016/j.seizure.2016.11.021
960:10.1016/S0140-6736(00)40184-4
1711:Epilepsia partialis continua
715:adrenocorticotrophic hormone
678:or neuroradiological studies
674:no pathological findings in
551:periventricular leukomalacia
529:congential infections (e.g.
1766:Juvenile myoclonic epilepsy
1744:Unverricht–Lundborg disease
1288:. Oxford University Press.
511:Foix–Chavany–Marie syndrome
234:Salaam or jackknife attacks
1904:
1683:Myoclonic astatic epilepsy
875:(1793–1848), who lived in
701:get their child evaluated
608:autistic spectrum disorder
1834:Epilepsy Action Australia
126:(caused during birth) or
1796:Landau–Kleffner syndrome
1630:Panayiotopoulos syndrome
1110:This Is Infantile Spasms
1080:"KCNT1-Related Epilepsy"
699:only 3 out of 10 parents
559:cerebrovascular accident
1678:Lennox–Gastaut syndrome
1560:Epilepsy and employment
1285:Neurobiology of Disease
852:Lennox-Gastaut syndrome
597:Lennox-Gastaut syndrome
526:neurometabolic diseases
80:is an uncommon-to-rare
1610:Temporal lobe epilepsy
1530:Electroencephalography
705:of seeing the spasms.
506:Incontinentia pigmenti
1615:Frontal lobe epilepsy
980:. Ole Daniel Enersen.
837:cognitive impairments
737:a restricted region.
522:Sturge–Weber syndrome
1851:Epilepsy Research UK
1635:Vertiginous epilepsy
1555:Epilepsy and driving
1506:Epilepsy in children
998:on December 13, 2016
942:West, W. J. (1841).
773:improve this section
541:brain damage due to
397:improve this section
277:improve this section
166:improve this section
1839:Epilepsy Foundation
1806:Epilepsy in animals
1486:Aura (warning sign)
665:diagnostic criteria
1726:Myoclonic epilepsy
1703:Status epilepticus
1396:External resources
873:William James West
478:tuberous sclerosis
453:cortical dysplasia
134:Signs and symptoms
90:William James West
1865:
1864:
1779:Related disorders
1774:
1773:
1620:Rolandic epilepsy
1419:
1418:
1251:10.1111/epi.13221
974:"West's syndrome"
928:978-0-7817-4995-4
809:
808:
801:
727:visual field loss
433:
432:
425:
313:
312:
305:
212:: Sudden, severe
210:Lightning attacks
202:
201:
194:
75:
74:
27:Medical condition
16:(Redirected from
1895:
1856:Epilepsy Society
1845:Epilepsy Outlook
1688:Epileptic spasms
1600:Gelastic seizure
1575:
1501:Neonatal seizure
1456:
1449:
1442:
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1114:
1113:
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1042:
1037:
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1014:
1008:
1007:
1005:
1003:
994:. Archived from
988:
982:
981:
970:
964:
963:
954:(911): 724–725.
939:
933:
932:
909:
804:
797:
793:
790:
784:
753:
745:
484:Aicardi syndrome
458:cerebral atrophy
428:
421:
417:
414:
408:
377:
369:
317:neurotransmitter
308:
301:
297:
294:
288:
257:
249:
197:
190:
186:
183:
177:
146:
138:
106:pattern (called
78:Epileptic spasms
71:
70:
42:Infantile spasms
33:Epileptic spasms
30:
21:
1903:
1902:
1898:
1897:
1896:
1894:
1893:
1892:
1868:
1867:
1866:
1861:
1828:Epilepsy Action
1810:
1770:
1720:
1697:
1693:Febrile seizure
1658:Absence seizure
1639:
1595:Complex partial
1564:
1547:Personal issues
1541:
1526:Investigations
1522:Anticonvulsants
1510:
1496:Epileptogenesis
1491:Postictal state
1469:
1460:
1420:
1415:
1414:
1391:
1390:
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1054:
1049:
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1025:
1023:
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1016:
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1001:
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989:
985:
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906:
901:
889:
869:
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805:
794:
788:
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743:
711:
691:
657:
637:
616:
574:
563:premature birth
531:Cytomegalovirus
429:
418:
412:
409:
394:
378:
367:
309:
298:
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289:
274:
258:
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228:Nodding attacks
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187:
181:
178:
163:
147:
136:
65:
46:Juvenile spasms
28:
23:
22:
15:
12:
11:
5:
1901:
1899:
1891:
1890:
1885:
1883:Epilepsy types
1880:
1870:
1869:
1863:
1862:
1860:
1859:
1853:
1848:
1842:
1836:
1831:
1825:
1818:
1816:
1812:
1811:
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1808:
1803:
1798:
1793:
1791:Todd's paresis
1788:
1782:
1780:
1776:
1775:
1772:
1771:
1769:
1768:
1763:
1758:
1757:
1756:
1754:Lafora disease
1751:
1749:MERRF syndrome
1746:
1741:
1730:
1728:
1722:
1721:
1719:
1718:
1713:
1707:
1705:
1699:
1698:
1696:
1695:
1690:
1685:
1680:
1675:
1670:
1665:
1663:Atonic seizure
1660:
1655:
1649:
1647:
1641:
1640:
1638:
1637:
1632:
1627:
1622:
1617:
1612:
1607:
1603:
1602:
1597:
1592:
1590:Simple partial
1587:
1583:
1581:
1572:
1566:
1565:
1563:
1562:
1557:
1551:
1549:
1543:
1542:
1540:
1539:
1537:Epileptologist
1534:
1533:
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1524:
1518:
1516:
1512:
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1508:
1503:
1498:
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1377:
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1315:Classification
1308:
1307:External links
1305:
1302:
1301:
1294:
1274:
1245:(12): 1941–9.
1225:
1196:(7): 1086–97.
1176:
1115:
1097:
1070:
1061:
1052:
1043:
1032:
1009:
983:
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934:
927:
903:
902:
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885:
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865:
859:
856:
844:cerebral palsy
807:
806:
757:
755:
748:
742:
739:
734:ketogenic diet
710:
707:
695:hypsarrhythmia
690:
687:
683:
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679:
672:
656:
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615:
612:
573:
570:
569:
568:
567:
566:
555:cephalhematoma
539:
534:
527:
524:
519:
516:Patau syndrome
513:
508:
500:
499:
498:
492:
489:cephalhematoma
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108:hypsarrhythmia
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35:
34:
26:
24:
14:
13:
10:
9:
6:
4:
3:
2:
1900:
1889:
1888:Seizure types
1886:
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1879:
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1875:
1873:
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789:December 2020
782:
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758:This section
756:
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703:within 1 week
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578:Down syndrome
572:Down syndrome
571:
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497:malformation.
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463:lissencephaly
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382:This section
380:
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364:
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356:
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350:
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344:
343:symptomatic:
341:
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262:This section
260:
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151:This section
149:
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121:
117:
111:
109:
105:
102:
101:pathognomonic
97:
96:
91:
87:
86:West syndrome
83:
79:
69:
63:
60:
58:
54:
51:
50:West syndrome
47:
43:
40:
36:
31:
19:
18:West Syndrome
1687:
1653:Tonic–clonic
1423:
1403:
1379:
1368:
1357:
1342:
1327:
1284:
1277:
1242:
1238:
1228:
1193:
1189:
1179:
1144:
1140:
1109:
1100:
1083:
1073:
1064:
1055:
1046:
1035:
1024:. Retrieved
1012:
1000:. Retrieved
996:the original
986:
977:
968:
951:
947:
937:
917:
907:
870:
861:
858:Epidemiology
841:
821:
817:
810:
795:
786:
771:Please help
759:
731:
712:
702:
698:
692:
684:
676:neurological
660:
658:
638:
628:
626:
619:
617:
605:
590:
575:
543:asphyxiation
537:hypoglycemia
518:(trisomy 13)
474:phakomatoses
448:microcephaly
436:
434:
419:
413:October 2022
410:
395:Please help
383:
360:
355:idiopathic:
354:
349:cryptogenic:
348:
342:
337:
332:
329:
314:
299:
293:October 2022
290:
275:Please help
263:
233:
227:
209:
203:
188:
182:October 2022
179:
164:Please help
152:
112:
93:
85:
77:
76:
49:
45:
41:
1645:Generalised
1002:January 10,
629:cryptogenic
621:cryptogenic
614:Cryptogenic
582:chromosomal
437:symptomatic
365:Symptomatic
38:Other names
1872:Categories
1668:Automatism
1515:Management
1381:DiseasesDB
1026:2023-10-28
948:The Lancet
899:References
881:The Lancet
723:Vigabatrin
719:prednisone
661:idiopathic
655:Idiopathic
601:chromosome
469:meningitis
467:bacterial
95:The Lancet
1878:Syndromes
1410:neuro/171
1405:eMedicine
1239:Epilepsia
1190:Epilepsia
1147:: 81–86.
877:Tonbridge
825:cognitive
813:prognosis
760:does not
741:Prognosis
709:Treatment
689:Diagnosis
384:does not
264:does not
214:myoclonic
153:does not
128:postnatal
124:perinatal
82:epileptic
62:Neurology
57:Specialty
1606:Epilepsy
1586:Seizures
1467:epilepsy
1463:Seizures
1269:26522016
1220:16026561
1163:27989601
1092:30234941
887:See also
833:physical
495:vascular
222:extensor
120:prenatal
1375:D013036
1260:4679547
1211:1360692
1171:4977080
1141:Seizure
867:History
829:motoric
781:removed
766:sources
635:Genetic
547:hypoxia
405:removed
390:sources
333:unknown
285:removed
270:sources
174:removed
159:sources
1474:Basics
1364:308350
1292:
1267:
1257:
1218:
1208:
1169:
1161:
1090:
925:
848:autism
476:(e.g.
238:Salaam
224:ones).
218:flexor
64:
1579:Focal
1353:345.6
1338:G40.4
1167:S2CID
1137:(PDF)
1021:(PDF)
667:are:
649:KCNT1
645:CDKL5
245:Cause
116:brain
48:, or
1858:(UK)
1847:(UK)
1841:(US)
1830:(UK)
1824:(US)
1465:and
1386:6788
1370:MeSH
1359:OMIM
1348:9-CM
1290:ISBN
1265:PMID
1216:PMID
1159:PMID
1088:PMID
1004:2012
923:ISBN
835:and
827:and
764:any
762:cite
388:any
386:cite
321:GABA
268:any
266:cite
157:any
155:cite
1344:ICD
1329:ICD
1255:PMC
1247:doi
1206:PMC
1198:doi
1149:doi
956:doi
775:by
721:.
641:ARX
592:EEG
545:or
491:and
399:by
279:by
168:by
104:EEG
1874::
1408::
1384::
1373::
1362::
1351::
1336::
1333:10
1263:.
1253:.
1243:56
1241:.
1237:.
1214:.
1204:.
1194:46
1192:.
1188:.
1165:.
1157:.
1145:44
1143:.
1139:.
1118:^
1108:.
1082:.
976:.
952:35
950:.
946:.
854:.
610:.
557:,
553:,
130:.
122:,
44:,
1455:e
1448:t
1441:v
1346:-
1331:-
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1298:.
1271:.
1249::
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1200::
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1151::
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958::
931:.
802:)
796:(
791:)
787:(
783:.
769:.
565:.
533:)
480:)
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420:(
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411:(
407:.
393:.
306:)
300:(
295:)
291:(
287:.
273:.
195:)
189:(
184:)
180:(
176:.
162:.
20:)
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