Impact of therapeutic hypothermia on infantile spasms: an observational cohort study

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dc.contributor.authorAbu Dhais, Farah
dc.contributor.authorMcNamara, Brian
dc.contributor.authorO'Mahony, Olivia
dc.contributor.authorMcSweeney, Niamh
dc.contributor.authorLivingstone, Vicki
dc.contributor.authorMurray, Deirdre M.
dc.contributor.authorBoylan, Geraldine B.
dc.contributor.funderScience Foundation Irelanden
dc.date.accessioned2019-10-16T05:46:38Z
dc.date.available2019-10-16T05:46:38Z
dc.date.issued2019-09-13
dc.description.abstractAim: To establish the incidence of infantile spasms in children in the southern region of the Republic of Ireland and to compare the incidence of infantile spasms before and after the introduction of therapeutic hypothermia in infants with hypoxic‐ischemic encephalopathy (HIE). Method: Children born between 2003 and 2015 and diagnosed with infantile spasms (epileptic spasms with or without hypsarrhythmia) in the first 2 years of life were identified through audits of electroencephalography reports and paediatric neurology patient lists. Data on live births were obtained from the regional hospital statistics databases. Medical charts of infantile spasm cases were reviewed for demographic information, diagnostic workup results, treatment response, disease course, and developmental outcome. Results: Forty‐two infants with infantile spasms were identified. The cumulative incidence of infantile spasms up to the age of 2 years was 4.01 per 10 000 live births. Difference due to sex was minimal (22 males, 20 females) and most infants were delivered at or near term with gestational ages ranging between 30.0 and 41.8 weeks (median [interquartile range] 39.6wks [38.1–40.0wks]). The aetiology for infantile spasms was identified in almost two‐thirds of cases, with HIE being the single most common cause (n=7). Other causes included chromosomal and monogenetic abnormalities (n=8). Infantile spasms occurred in moderate and severe grades of HIE, with a significantly higher incidence in those with severe HIE (p=0.029). Infants with severe HIE who did not receive therapeutic hypothermia were six times more likely to develop infantile spasms compared to those who did, but the difference was not statistically significant (4 out of 16 vs 1 out of 24, p=0.138). Interpretation: This study provides detailed information about infantile spasms before and after the introduction of therapeutic hypothermia. HIE severity is a risk factor for the development of infantile spasms. The introduction of therapeutic hypothermia may have had an impact, but the effect was hard to ascertain in this cohort due to the small number of infants.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationAbu Dhais, F., McNamara, B., O'Mahony, O., McSweeney, N., Livingstone, V., Murray, D. M. and Boylan, G. B., 'Impact of therapeutic hypothermia on infantile spasms: an observational cohort study', Developmental Medicine & Child Neurology, (8pp.) [In press]. DOI: 10.1111/dmcn.14331en
dc.identifier.doi10.1111/dmcn.14331en
dc.identifier.eissn1469-8749
dc.identifier.endpage8en
dc.identifier.issn0012-1622
dc.identifier.journaltitleDevelopmental Medicine and Child Neurologyen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/8781
dc.language.isoenen
dc.publisherJohn Wiley & Sons, Inc.en
dc.relation.projectinfo:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2272/IE/Irish Centre for Fetal and Neonatal Translational Research (INFANT)/en
dc.relation.urihttps://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.14331
dc.rights©2019 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectHypsarrhythmiaen
dc.subjectSpasmen
dc.subjectInfantileen
dc.subjectWesten
dc.subjectSalaam/salamen
dc.subjectEpileptic encephalopathyen
dc.titleImpact of therapeutic hypothermia on infantile spasms: an observational cohort studyen
dc.typeArticle (peer-reviewed)en
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