Current Knowledge, Attitude and Practice (KAP) of Pediatricians on Infantile Spasms and the Way Forward

Excerpt

Epileptic spasm or West syndrome is a severe age related epileptic and developmental encephalopathy that classically presents during infancy. The syndrome is characterized by clusters of axial flexion/extension or mixed jerks (clinical spasm) and an electroencephalographic signature of hypsarrhythmia. Although developmental delay or regression was originally described in all cases, it may not necessarily be evident at disease onset or might be difficult to ascertain and therefore its presence or absence is no longer considered relevant for establishing the diagnosis [1]. West syndrome has an estimated incidence of 1.5–4.5 cases per 10,000 live births [1]. The neurological and developmental outcome in often poor. However, a shorter interval from the onset of spasms to treatment initiation may improve long-term neurodevelopmental outcome. A shorter lead time to treatment (LTTT) of <4 wk is associated with 51.9% improvement in neurodevelopmental outcome compared to >4 wk LTTT [2]. Lead time to treatment in Indian studies varies from 3 to 7 mo [3]. In this regard the current study by Vaddi and colleagues becomes extremely relevant. The authors have assessed the knowledge, attitude and practice (KAP) of Indian pediatricians on infantile spasms [4]. Their survey showed that a substantial number of participating pediatricians lacked precise knowledge of evidence based practices in West syndrome. Majority (90%) of the pediatricians felt that there was a need for increased awareness while 2/3rd felt that available information was insufficient. …