ObjectiveTo optimize the therapy protocols of high dose prednisone combined with topiramate (TPM) in children with infantile spasms (IS). MethodsSixty cases were collected in our hospital from September 2012 to September 2013 and randomly divided into two groups(n=30) and followed-up for more than 6 months.The spasms were assesses by video-electroencephalogram (VEEG) monitoring including awake and asleep states before treatment, after two weeks of therapy and the end of the courses respectively.And the Gessel developmental quotient (DQ) scores were performed before treatment and after six months of therapy. ResultsFor the unresponders to high dose prednisone in one week of therapy, there were 46.67%and 60.00% in test group higher than 31.25% and 37.50% in control group respectively in 2 week and in the end of treatment.And the rate of complete resolution of hypsarrhythmia in the test group was 46.67% and 60.00% higher than 25.00% and 37.50% in control group respectively in 2 week and in the end of treatment.But there were no statistical significances between two groups(P >0.05).The incidence of side effects(83.33% vs. 80.00%) and the relapse rate(39.14% vs. 40.00%), were not statistically significant between two groups(P >0.05).The responsive rates for the cases with the lead time within 2 months higher than beyond 2 months in two groups respectively in 2 weeks and in the end of treatment. ConclusionsThe protocol of the test group was superior to that of the control group.The responsive rates of children within 2 months of lead time were higher than beyond 2 months, which indicates that early diagnosis and early treatment would improve efficacy and have an important influence on the prognosis of IS.
ObjectiveTo compare and analyze the electroencephalographic (EEG) characteristics of infants with infantile epileptic spasms syndrome (IESS) and healthy infants during sleep using power spectral density (PSD) analysis. MethodsInfants aged 5 to 9 months with IESS were included, along with an equal number of age-matched healthy controls. EEG signals during sleep were recorded using the Nihon Kohden EEG-1200C system. The energy distribution in the theta (θ), alpha (α), sigma (σ), and beta (β) frequency bands, as well as the morphology and values of PSD within the 4 ~ 30 Hz range, were analyzed. Additionally, spectral entropy (SpEn) was calculated to evaluate signal complexity. Results A total of 10 IESS patients and 10 healthy infants were included. There were no significant differences in gender or age between the two groups (P=0.64, P=0.88). In both groups, PSD values showed a linear decreasing trend with increasing frequency. However, the IESS group showed notable differences in PSD morphology, amplitude, and energy distribution compared to controls. These included the absence of a σ-band peak, greater PSD dispersion across electrodes, significant alterations in energy distribution across θ, α, σ, and β bands, and significantly higher PSD values in the 4 ~ 30 Hz range (P<0.000 1). SpEn analysis revealed significantly elevated spectral entropy across the sigma band in the IESS group, indicating a lack of dominant frequencies, increased complexity, reduced rhythmicity, and enhanced disorder. In contrast, healthy controls exhibited elevated SpEn in the alpha band, reflecting the physiological reduction or disappearance of dominant alpha rhythms during sleep. Conclusion Infants with IESS demonstrate distinct EEG characteristics in both PSD and SpEn analyses compared to healthy infants. These quantitative spectral features reflect the underlying abnormalities of EEG in IESS and provide objective insights that complement conventional visual assessment, offering a novel perspective for early diagnosis and therapeutic monitoring.