DEVELOPMENTAL OUTCOMES IN CHILDREN RECEIVING RESECTION SURGERY FOR MEDICALLY INTRACTABLE INFANTILE SPASMS

Two-year postsurgical developmental outcomes were assessed in 24 child ren with infantile spasms who underwent resective surgery. The mean ag e of onset of infantile spasms was 12.0 weeks and the mean age at surg ery was 20.8 months. Developmental outcomes were assessed using the Vi neland Adaptive Behavior Scales (VABS). There was a significant increa se in developmental level at a years postsurgery compared with presurg ical levels. At 2 years postsurgery only one of the children in this s eries was severely retarded. The developmental outcomes of patients in the series were better than those in prior studies of symptomatic pat ients receiving medical treatment for infantile spasms. It is surprisi ng that the children in the UCLA series frequently had developmental o utcomes equal to and sometimes superior to other groups of children wi th infantile spasms, since all the UCLA patients were symptomatic, had neurologic deficits and had failed to respond to adrenocorticotrophic hormone (ACTH) and antiepileptic drugs. The 2-year postsurgery develo pmental outcomes were best for the children who received surgery when they were relatively young and who had the highest level of developmen tal attainments presurgically.