EVOLUTIONAL CHANGES AND OUTCOME OF WEST-SYNDROME - CORRELATION WITH MAGNETIC-RESONANCE-IMAGING FINDINGS

The prognosis and evolutional changes of 77 patients with West syndrom e (WS) were studied after patients were classified into four groups on the basis of their magnetic resonance imaging (MRI) findings: anomaly , perinatal injury, normal, and the other groups. The average age at o nset of spasms was earliest in the patients with anomalies and latest in patients with normal MRI findings. Patients with normal MRI finding s had the shortest duration of spasms, and patients with anomalies had the longest duration of spasms. Antecedent seizures were observed in 6 patients (3 patients with anomalies, 1 patient with normal MRI findi ngs, and 2 patients with other abnormalities). Thirty-five patients ha d subsequent seizures. Patients with anomalies often had partial seizu res and patients with perinatal injuries often had generalized seizure s. Seizures were infrequent in patients with normal MRI findings. Deve lopmental outcome was best in the patients with normal MRI findings an d worst in patients with perinatal injuries. Various types of epilepti c syndromes occurred subsequent to WS in patients with anomalies, alth ough nonspecific symptomatic generalized epilepsy was common in patien ts with perinatal injuries. These results suggest that seizure prognos is, evolutional changes in seizures, and developmental outcome are dif ferent among the types of brain lesions.