WEST SYNDROME FOLLOWING DEEP HYPOTHERMIC INFANT CARDIAC-SURGERY

Postoperative seizures are among the more common complications of card iac surgery in children. These seizures have traditionally been consid ered benign, transient phenomena with little, if any, prognostic signi ficance. We report 4 infants with early postoperative seizures followi ng cardiac surgery who later developed the previously unreported compl ication of West syndrome, with infantile spasms, hypsarrhythmia, and d evelopmental delay. This group constitutes 6% of 67 infant spasms eval uated over a 5-year period at Boston Childrens' Hospital. The postoper ative seizures in these 4 patients were more difficult than usual to c ontrol with antiepileptic therapy; otherwise no intra- or perioperativ e features distinguished these infants who later developed West syndro me from infants with apparently benign ''postpump seizures.''