Author/Editor		Krivec, Uroš; Lozar, Jana
Title		Rast glave pri otrocih z infantilnimi spazmi
Type		monografija
Place		Ljubljana
Publisher		Medicinska fakulteta
Publication year		2000
Volume		str. 39
Language		slo
Abstract		BACKGROUND Infantile spasms (lS) begin in a very active phase of brain development. Since changes in head circumference (HC) accurately reflect changes in brain growth during infancy, we assumed the possibility that epileptic activity which interferes with brain development would also lead to head growth failure in children affected by IS. The aim of the study was to determine the relationship between outcome and HC at different age or different time after onset of IS. PATIENTS AND METHODS The sfudy involved 38 children (17 boys and 21 girls) with history of IS and no other obvious cause for an abnormal head growth (i.e. hydrocephalus, chromosomal or genetic abnormality). The data for HC were gathered from patients' medical documentation. HCs below the 10th percentile of Slovene population were considered abnormal. In terms of cognitive and neuro-developmental outcome the children were grouped into four categories (1-normal to 4-sever impairment). t-test and multiple linear regression were used to test the relationship between HC and outcome. RESULTS Abnormal HC in the 4th and the 5th month after onset of spasms was significantly associated with abnormal mental development ( 2.8 vs.1.7, p= 0.004). This relation persisted even when several factors like etiology, duration of spasms, gestational age and delayed development before onset of spasms were controlled. In the 4th month after onset of spasms normal mental development was present in only 12% (1:8) of children with abnormal head size. The mean HC of the children with IS was not significantly lower than the mean HC in normal population, eventhough the proportion of the children with abnormal head size (27%) was larger. CONCLUSIONS It was found that HC represents an important predictive factor for cognitive outcome in children with history of IS. Since HC can be measured quickly and easily its considerable predictive role in follow up should not be ignored in any children and specially not in those with IS.
Descriptors		SPASMS, INFANTILE HEAD CEPHALOMETRY EPILEPSY PSYCHOMOTOR DISORDERS