Infantile spasms: Neurological and developmental follow-up – A comparison between two ethnic groups: Israeli Jews and Bedouin in the South of Israel
Gideon Vardi, Shir Melamed Snapir, Joav Merick, Zamir Shorer, Jacov Levy, Michael Friger, Aharon Galil
Med Sci Monit 2005; 11(3): CR117-122
Available online: 2005-03-01
Background: The aim of this study was to examine all cases of infantile spasms (IS) diagnosed at the Soroka University Medical Center, Ben Gurion University, Israel during 1981–1997.
Material/Methods: 31 children, 17 (55%) males. 17 (55%) were Jews and 14 (45%) Bedouins. Four (13%) died. Data was gathered from hospital fi les, neuropediatric unit and Zusman Child Development Center. Demographic and ethnic data, characteristics of the disease type of seizures, EEG pattern imaging studies, type of treatment, psychomotor development, rehabilitation and educational services were analysed.
Results: Mean age at diagnosis 7.22 months. Etiology for one third was pre- or perinatal insult, one third postnatal and one third unknown. 26 (84%) were symptomatic and fi ve (16%) cryptogenic. Signifi cant statistical difference was found with more Bedouin children symptomatic with moderate or severe mental retardation, cerebral palsy with severe motor diffi culties and recurrence of the disease.
Statistically signifi cant correlation existed between poor response to initial treatment and placement in special education, recurrence of disease and cerebral palsy with moderate or severe motor diffi culties, the appearence of a different type of epilepsy during follow-up and placement in special education. 18 children (58%) received fi rst treatment with ACTH, 10 (32%) children with IVIG (immunoglobolin iv), 3 (10%) with neither ACTH nor IVIG. Regarding therapy response we found no signifi cant difference between Jews and Bedouins.
Conclusions: No signifi cant statistical difference was found between the two treatments concerning clinical course or developmental follow-up. Due to small numbers multi-center research is needed.
Keywords: Arabs - statistics & numerical data, Child Development - drug effects, Israel - epidemiology, Jews - statistics & numerical data, Spasms, Infantile - epidemiology, Adrenocorticotropic Hormone - therapeutic use, Anticonvulsants - therapeutic use, Arabs - statistics & numerical data, Child Development - drug effects, Ethnic Groups - statistics & numerical data, Follow-Up Studies, Incidence, Israel - epidemiology, Jews - statistics & numerical data, Spasms, Infantile - etiology, Time Factors