Epileptic spasms in infants: can video-EEG reveal the disease’s etiology? A retrospective study and literature review

Autores
Falsaperla, Raffaele; Sciuto, Sarah; Privitera, Grete Francesca; Tardino, Lucia Giovanna; Costanza, Giuseppe; Di Nora, Alessandra; Caraballo, Roberto Horacio; Ruggieri, Martino
Año de publicación
2023
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Objective: Epileptic spasms are a type of seizure defined as a sudden flexion or extension predominantly of axial and/or truncal limb muscles that occur with a noticeable periodicity. Routine electroencephalogram supports the diagnosis of epileptic spasms, which can occur due to different causes. The present study aimed to evaluate a possible association between the electro-clinical pattern and the underlying etiology of epileptic spasms in infants.Materials and methods: We retrospectively reviewed the clinical and video-EEG data on 104 patients (aged from 1 to 22 months), admitted to our tertiary hospital in Catania and the tertiary hospital in Buenos Aires, from January 2013 to December 2020, with a confirmed diagnosis of epileptic spasms. We divided the patient sample into structural, genetic, infectious, metabolic, immune, and unknown, based on etiology. Fleiss´ kappa (К) was used to assess agreement among raters in the electroencephalographic interpretation of hypsarrhythmia. A multivariate and bivariate analysis was conducted to understand the role of the different video-EEG variables on the etiology of epileptic spasms. Furthermore, decision trees were constructed for the classification of variables.Results: The results showed a statistically significant correlation between epileptic spasms semiology and etiology: flexor spasms were associated with spasms due to genetic cause (87.5%; OR < 1); whereas mixed spasms were associated with spasms from a structural cause (40%; OR < 1). The results showed a relationship between ictal and interictal EEG and epileptic spasms etiology: 73% of patients with slow waves and sharp waves or slow waves on the ictal EEG, and asymmetric hypsarrhythmia or hemi hypsarrhythmia on the interictal EEG, had spasms with structural etiology, whereas 69% of patients with genetic etiology presented typical interictal hypsarrhythmia with high-amplitude polymorphic delta with multifocal spike or modified hypsarrhythmia on interictal EEG and slow waves on the ictal EEG.Conclusion: This study confirms that video-EEG is a key element for the diagnosis of epileptic spasms, also playing an important role in the clinical practice to determine the etiology.
Fil: Falsaperla, Raffaele. University Hospital Policlinico “Rodolico-San Marco; Italia
Fil: Sciuto, Sarah. University of Catania; Italia
Fil: Privitera, Grete Francesca. University of Catania; Italia
Fil: Tardino, Lucia Giovanna. University Hospital Policlinico “Rodolico-San Marco; Italia
Fil: Costanza, Giuseppe. University of Catania; Italia
Fil: Di Nora, Alessandra. Universidad de Catania; Italia
Fil: Caraballo, Roberto Horacio. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Ruggieri, Martino. Universidad de Catania; Italia
Materia
ELECTROCLINICAL PATTERN
EPILEPTIC SPASMS
NEWBORN
SEIZURES
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/243423

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network_name_str CONICET Digital (CONICET)
spelling Epileptic spasms in infants: can video-EEG reveal the disease’s etiology? A retrospective study and literature reviewFalsaperla, RaffaeleSciuto, SarahPrivitera, Grete FrancescaTardino, Lucia GiovannaCostanza, GiuseppeDi Nora, AlessandraCaraballo, Roberto HoracioRuggieri, MartinoELECTROCLINICAL PATTERNEPILEPTIC SPASMSNEWBORNSEIZUREShttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Objective: Epileptic spasms are a type of seizure defined as a sudden flexion or extension predominantly of axial and/or truncal limb muscles that occur with a noticeable periodicity. Routine electroencephalogram supports the diagnosis of epileptic spasms, which can occur due to different causes. The present study aimed to evaluate a possible association between the electro-clinical pattern and the underlying etiology of epileptic spasms in infants.Materials and methods: We retrospectively reviewed the clinical and video-EEG data on 104 patients (aged from 1 to 22 months), admitted to our tertiary hospital in Catania and the tertiary hospital in Buenos Aires, from January 2013 to December 2020, with a confirmed diagnosis of epileptic spasms. We divided the patient sample into structural, genetic, infectious, metabolic, immune, and unknown, based on etiology. Fleiss´ kappa (К) was used to assess agreement among raters in the electroencephalographic interpretation of hypsarrhythmia. A multivariate and bivariate analysis was conducted to understand the role of the different video-EEG variables on the etiology of epileptic spasms. Furthermore, decision trees were constructed for the classification of variables.Results: The results showed a statistically significant correlation between epileptic spasms semiology and etiology: flexor spasms were associated with spasms due to genetic cause (87.5%; OR < 1); whereas mixed spasms were associated with spasms from a structural cause (40%; OR < 1). The results showed a relationship between ictal and interictal EEG and epileptic spasms etiology: 73% of patients with slow waves and sharp waves or slow waves on the ictal EEG, and asymmetric hypsarrhythmia or hemi hypsarrhythmia on the interictal EEG, had spasms with structural etiology, whereas 69% of patients with genetic etiology presented typical interictal hypsarrhythmia with high-amplitude polymorphic delta with multifocal spike or modified hypsarrhythmia on interictal EEG and slow waves on the ictal EEG.Conclusion: This study confirms that video-EEG is a key element for the diagnosis of epileptic spasms, also playing an important role in the clinical practice to determine the etiology.Fil: Falsaperla, Raffaele. University Hospital Policlinico “Rodolico-San Marco; ItaliaFil: Sciuto, Sarah. University of Catania; ItaliaFil: Privitera, Grete Francesca. University of Catania; ItaliaFil: Tardino, Lucia Giovanna. University Hospital Policlinico “Rodolico-San Marco; ItaliaFil: Costanza, Giuseppe. University of Catania; ItaliaFil: Di Nora, Alessandra. Universidad de Catania; ItaliaFil: Caraballo, Roberto Horacio. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Ruggieri, Martino. Universidad de Catania; ItaliaFrontiers Media2023-06info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/243423Falsaperla, Raffaele; Sciuto, Sarah; Privitera, Grete Francesca; Tardino, Lucia Giovanna; Costanza, Giuseppe; et al.; Epileptic spasms in infants: can video-EEG reveal the disease’s etiology? A retrospective study and literature review; Frontiers Media; Frontiers in Neurology; 14; 6-2023; 1-91664-2295CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.3389/fneur.2023.1204844info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:18:31Zoai:ri.conicet.gov.ar:11336/243423instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:18:31.508CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Epileptic spasms in infants: can video-EEG reveal the disease’s etiology? A retrospective study and literature review
title Epileptic spasms in infants: can video-EEG reveal the disease’s etiology? A retrospective study and literature review
spellingShingle Epileptic spasms in infants: can video-EEG reveal the disease’s etiology? A retrospective study and literature review
Falsaperla, Raffaele
ELECTROCLINICAL PATTERN
EPILEPTIC SPASMS
NEWBORN
SEIZURES
title_short Epileptic spasms in infants: can video-EEG reveal the disease’s etiology? A retrospective study and literature review
title_full Epileptic spasms in infants: can video-EEG reveal the disease’s etiology? A retrospective study and literature review
title_fullStr Epileptic spasms in infants: can video-EEG reveal the disease’s etiology? A retrospective study and literature review
title_full_unstemmed Epileptic spasms in infants: can video-EEG reveal the disease’s etiology? A retrospective study and literature review
title_sort Epileptic spasms in infants: can video-EEG reveal the disease’s etiology? A retrospective study and literature review
dc.creator.none.fl_str_mv Falsaperla, Raffaele
Sciuto, Sarah
Privitera, Grete Francesca
Tardino, Lucia Giovanna
Costanza, Giuseppe
Di Nora, Alessandra
Caraballo, Roberto Horacio
Ruggieri, Martino
author Falsaperla, Raffaele
author_facet Falsaperla, Raffaele
Sciuto, Sarah
Privitera, Grete Francesca
Tardino, Lucia Giovanna
Costanza, Giuseppe
Di Nora, Alessandra
Caraballo, Roberto Horacio
Ruggieri, Martino
author_role author
author2 Sciuto, Sarah
Privitera, Grete Francesca
Tardino, Lucia Giovanna
Costanza, Giuseppe
Di Nora, Alessandra
Caraballo, Roberto Horacio
Ruggieri, Martino
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv ELECTROCLINICAL PATTERN
EPILEPTIC SPASMS
NEWBORN
SEIZURES
topic ELECTROCLINICAL PATTERN
EPILEPTIC SPASMS
NEWBORN
SEIZURES
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Objective: Epileptic spasms are a type of seizure defined as a sudden flexion or extension predominantly of axial and/or truncal limb muscles that occur with a noticeable periodicity. Routine electroencephalogram supports the diagnosis of epileptic spasms, which can occur due to different causes. The present study aimed to evaluate a possible association between the electro-clinical pattern and the underlying etiology of epileptic spasms in infants.Materials and methods: We retrospectively reviewed the clinical and video-EEG data on 104 patients (aged from 1 to 22 months), admitted to our tertiary hospital in Catania and the tertiary hospital in Buenos Aires, from January 2013 to December 2020, with a confirmed diagnosis of epileptic spasms. We divided the patient sample into structural, genetic, infectious, metabolic, immune, and unknown, based on etiology. Fleiss´ kappa (К) was used to assess agreement among raters in the electroencephalographic interpretation of hypsarrhythmia. A multivariate and bivariate analysis was conducted to understand the role of the different video-EEG variables on the etiology of epileptic spasms. Furthermore, decision trees were constructed for the classification of variables.Results: The results showed a statistically significant correlation between epileptic spasms semiology and etiology: flexor spasms were associated with spasms due to genetic cause (87.5%; OR < 1); whereas mixed spasms were associated with spasms from a structural cause (40%; OR < 1). The results showed a relationship between ictal and interictal EEG and epileptic spasms etiology: 73% of patients with slow waves and sharp waves or slow waves on the ictal EEG, and asymmetric hypsarrhythmia or hemi hypsarrhythmia on the interictal EEG, had spasms with structural etiology, whereas 69% of patients with genetic etiology presented typical interictal hypsarrhythmia with high-amplitude polymorphic delta with multifocal spike or modified hypsarrhythmia on interictal EEG and slow waves on the ictal EEG.Conclusion: This study confirms that video-EEG is a key element for the diagnosis of epileptic spasms, also playing an important role in the clinical practice to determine the etiology.
Fil: Falsaperla, Raffaele. University Hospital Policlinico “Rodolico-San Marco; Italia
Fil: Sciuto, Sarah. University of Catania; Italia
Fil: Privitera, Grete Francesca. University of Catania; Italia
Fil: Tardino, Lucia Giovanna. University Hospital Policlinico “Rodolico-San Marco; Italia
Fil: Costanza, Giuseppe. University of Catania; Italia
Fil: Di Nora, Alessandra. Universidad de Catania; Italia
Fil: Caraballo, Roberto Horacio. Gobierno de la Ciudad de Buenos Aires. Hospital de Pediatría "Juan P. Garrahan"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Ruggieri, Martino. Universidad de Catania; Italia
description Objective: Epileptic spasms are a type of seizure defined as a sudden flexion or extension predominantly of axial and/or truncal limb muscles that occur with a noticeable periodicity. Routine electroencephalogram supports the diagnosis of epileptic spasms, which can occur due to different causes. The present study aimed to evaluate a possible association between the electro-clinical pattern and the underlying etiology of epileptic spasms in infants.Materials and methods: We retrospectively reviewed the clinical and video-EEG data on 104 patients (aged from 1 to 22 months), admitted to our tertiary hospital in Catania and the tertiary hospital in Buenos Aires, from January 2013 to December 2020, with a confirmed diagnosis of epileptic spasms. We divided the patient sample into structural, genetic, infectious, metabolic, immune, and unknown, based on etiology. Fleiss´ kappa (К) was used to assess agreement among raters in the electroencephalographic interpretation of hypsarrhythmia. A multivariate and bivariate analysis was conducted to understand the role of the different video-EEG variables on the etiology of epileptic spasms. Furthermore, decision trees were constructed for the classification of variables.Results: The results showed a statistically significant correlation between epileptic spasms semiology and etiology: flexor spasms were associated with spasms due to genetic cause (87.5%; OR < 1); whereas mixed spasms were associated with spasms from a structural cause (40%; OR < 1). The results showed a relationship between ictal and interictal EEG and epileptic spasms etiology: 73% of patients with slow waves and sharp waves or slow waves on the ictal EEG, and asymmetric hypsarrhythmia or hemi hypsarrhythmia on the interictal EEG, had spasms with structural etiology, whereas 69% of patients with genetic etiology presented typical interictal hypsarrhythmia with high-amplitude polymorphic delta with multifocal spike or modified hypsarrhythmia on interictal EEG and slow waves on the ictal EEG.Conclusion: This study confirms that video-EEG is a key element for the diagnosis of epileptic spasms, also playing an important role in the clinical practice to determine the etiology.
publishDate 2023
dc.date.none.fl_str_mv 2023-06
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/243423
Falsaperla, Raffaele; Sciuto, Sarah; Privitera, Grete Francesca; Tardino, Lucia Giovanna; Costanza, Giuseppe; et al.; Epileptic spasms in infants: can video-EEG reveal the disease’s etiology? A retrospective study and literature review; Frontiers Media; Frontiers in Neurology; 14; 6-2023; 1-9
1664-2295
CONICET Digital
CONICET
url http://hdl.handle.net/11336/243423
identifier_str_mv Falsaperla, Raffaele; Sciuto, Sarah; Privitera, Grete Francesca; Tardino, Lucia Giovanna; Costanza, Giuseppe; et al.; Epileptic spasms in infants: can video-EEG reveal the disease’s etiology? A retrospective study and literature review; Frontiers Media; Frontiers in Neurology; 14; 6-2023; 1-9
1664-2295
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/doi/10.3389/fneur.2023.1204844
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Frontiers Media
publisher.none.fl_str_mv Frontiers Media
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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