Epilepsy development in infancy with epileptic discharges

As a part of the study to prevent West syndrome (WS) by early treatment, we assessed what kind of epilepsy developed in infants who showed epileptic discharges in early infancy. EEG examinations were performed on 116 infants born from 1997 to September 2004, both before and after 3 months of corrected age (CA). We divided 45 infants who showed epileptic discharges in early infancy into two groups according to the existence of periventricular leukomalacia (PVL) and retrospectively performed the course observation at the survey point on April 1 in 2005. Out of 45 infants showing epileptic discharges in early infancy, 26 developed WS. Compared with infants without PVL, infants with PVL were more likely to develop WS than infants without PVL. Furthermore, infants with PVL were more likely to develop WS than other types of epilepsy. Namely, 11 out of 17 infants with PVL developed WS at the survey point. All infants with WS showed initial epileptic discharges before 5 months of corrected age (CA), and most of them (except for five) had initial epileptic discharges before 3 months of CA. There were two infants who once developed hypsarrhythmia on EEG; however, after starting VPA therapy, they did not develop WS with the improvement of EEG findings, and one was presented here in detail. We proposed that preterm infants with PVL who showed epileptic discharges before 3 months of CA should be treated by antiepileptic drugs to prevent the onset of WS syndrome.