Epileptic spasms: A South African overview of aetiologies, interventions, and outcomes

Epileptic spasms is a particular type of seizure that occurs most commonly in the first year of life. The infant appears to bend their hips and knees with outstretched arms and drops their head. Each event lasts around 1 to 2 seconds. These tend to occur in close succession to one another, usually when the infant is about to fall asleep or upon awakening. The infant is often very distressed by these events. These seizures may be associated with a delay in development or a loss of developmental milestones. Recognition of this type of seizure is often delayed in our setting and frequently mistaken for colic. It is very important if you notice these seizures in your child to take your child to your nearest healthcare facility immediately, as the sooner these seizures are treated, the better the overall developmental outcome.

The most common cause of this seizure type in southern Africa is brain injury around the time of birth or abnormalities in the formation of the brain itself during early pregnancy. Seizures are treatable with oral (and sometimes an injectable) medication, however, infants would need to be admitted to hospital for a few days to ensure the infant does not experience any side effects of treatment such as lethargy or excessive irritability. One of these treatments is a form of corticosteroids, which may suppress the immune system so underlying infections (such as tuberculosis) should be excluded beforehand. During the hospital admission, an electroencephalogram (EEG) (a painless test where stickers will be placed on the child's head so that the electrical activity in the brain can be recorded) will be performed.