Cognitive outcome in children with infantile spasms using a standardized treatment protocol. A five-year longitudinal study

Aim: To evaluate the long-term developmental trajectory of children with infantile spasms (IS) and identify clinical protective risk factors associated their cognitive outcome.Methods: We analyzed five-year follow-up results 41 (13 female) from previously published cohort (n = 68) recruited in a multicenter randomized controlled trial for 2-years, examining effect an adjunctive therapy (Flunarizine) on standardized IS treatment. The were subsequently monitored open-label study additional 3 years. Vineland Adaptive Behavior Scale, second edition, either Stanford-Binet Intelligence Fifth Edition (SB5) or Bayley Scales Infant Development, edition (BSID-II) used as outcome measures.Results: Etiology was strongest predictor outcome. Children no identified etiology (NIE) showed progressive improvement functions, mostly occurring between 2 5 years post-diagnosis. Conversely, symptomatic predictive poorer Developmental delay, other seizure types (before after diagnosis), persistent electroencephalographic abnormalities following treatment poor outcome.Interpretation: Given 5-year improvement, should undergo assessment before school entry. Factors influencing emphasize importance thorough investigation evidence-based