West syndrome: the importance of early diagnosis

Case presentation: Term newborn, appropriate for gestational age, female, normal neonatal screenings, vaginal birth, Apgar ⅞. Diagnosed with congenital syphilis, pulmonary hypertension, convulsive syndrome and altered thyroid-stimulating hormone by maternal levothyroxine use during pregnancy. At maternity, infant presented frequent seizures, receiving levetiracetam phenobarbital, in addition to crystalline penicillin. Magnetic resonance image showed diffuse signs of severe intracranial multicystic encephalomalacence, significant cortex loss. Received discharged after 36 days persistence epileptic seizures. Was referred a neuropediatrician, but without follow-up. It evolved at 4 months life, requiring hospitalization, presenting no neuropsychomotor development, conjugated supraversion eyes, regular sucking, fixation look support head, social smile or palmar grip sign, episodes as fast spasms nystagmus that are repeated several times day. Electroencephalogram (EEG) abundant paroxysm acute waves multifocal projection spicules, suggestive hipsarrhythmia. West Syndrome, he received vigabatrin, valproic acid, associated adrenocorticotrophic hormone, fewer daily