Abstract
A prognostic study was carried out on 83 cases of the West syndrome followed-up for over three years after the first visit. They were divided into two groups, that is an idiopathic (13 cases) and a symptomatic (70 cases) groups. The criteria for idiopathic cases were as follows: 1) no etiology 2) normal development prior to the onset of tonic spasms 3) no antecedent seizures before tonic spasms 4) no abnormal neurological findings 5) no asymmetry in the hypsarhythmia 6) no abnormal neuroradiological findings.
The mental and seizure prognoses were significantly favorable in the idiopathic group, comparing with the symptomatic. 10 (76.9%) of 13 idiopathic cases and 13 (18.6%) of 70 symptomatic cases were mentally normal, and clinical seizures were controlled in all the idiopathic cases and only 38 (54.3%) of 70 symptomatic cases at the follow-up. Throughout the clinical courses, none of the idiopathic cases and 34 (48.6%) of 70 symptomatic cases evolved into the Lennox-Gastaut syndrome (LGS). Cases evolving into LGS were significantly less favorable in both mental and seizure prognoses, comparing with those without such evolution. This finding suggested that the persistence of seizures may provoke mental deterioration.
