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
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/243423
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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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13.070432 |