Epidemiology of West syndrome in Singapore

The incidence of West syndrome (WS) was determined by a search of reports o f electroencephalograms (EEG) recorded in 1998 and 1999 in all public hospi tals in Singapore. Amongst records of patients born in 1998, nine were foun d with EEG features of hypsarrhythmia or modified hypsarrhythmia with onset of seizures between January 1, 1998 and December 31, 1999. The medical rec ords of these patients were reviewed. The population of children born in 19 98 was 43,664. In 1998 and 1999, 67% of all hospital admissions for patient s 2 years or younger in Singapore were in public hospitals. The cumulative incidence of WS in Singapore corrected for the percentage of hospital admis sions to public hospitals was 3.1/10,000 live births. The corrected cumulat ive incidences in Chinese, Malays and Indians were 2.7, 3.1 and 3.3 per 10, 000, respectively. Three cases were idiopathic; three were due to congenita l structural lesions of the brain; one each had periventricular leucomalaci a, intracranial hemorrhage and severe intrauterine growth retardation. None of the patients were normal at follow up. The three patients with idiopath ic WS had mild global developmental delay and the other six cases had cereb ral palsy and severe mental retardation. With the best modern medical treat ment, possibly only two of the nine cases of WS may have been prevented. (C ) 2001 Elsevier Science B.V. All rights reserved.