NEURORADIOLOGIC ASPECTS OF WEST-SYNDROME

Cranial computed tomography (CT) or magnetic resonance imaging (MRI), or both, of 143 patients with West syndrome were retrospectively revie wed. Twenty-four children had normal CT scans. The most striking findi ngs on pathologic scans were cerebral atrophy, ventricular enlargement , and encephalomalacia. Of 78 children who underwent MRI, 14 had norma l scans. Cerebral malformations, cerebral atrophy, and delayed myelina tion were the most common pathologic findings and were observed in 25, 20, and 16 of the cases, respectively. MRI was found to be more infor mative in 21 of the 27 patients who underwent both neuroimaging method s. In fact, in two patients with normal CT scans, MRI revealed delayed myelination and hyperintensity of the hippocampal area on T-2-weighte d images in one and increased intensity of basal ganglia on T-1-weight ed images in the other. On the basis of all data, four patients were c lassified as cryptogenic and 126 as symptomatic. The most frequent eti ologic factors were perinatal asphyxia, cerebral malformations, and in fections, encountered in 34, 25, and 24 of the children, respectively. Twenty-one cases could be classified solely on the basis of the data obtained with neuroimaging modalities. The data confirm and provide ad ditional details of the ways in which neuroimaging, especially MRI, is useful in distinguishing between cryptogenic and symptomatic cases of West syndrome. (C) 1998 by Elsevier Science Inc. All rights reserved.