Hypsarrhythmia paroxysm index: A tool for early prediction of infantile spasms

Epilepsy Research
Attila AltunelEmine Özlem Altunel

Abstract

Recurrence of infantile spasms (ISs) is common subsequent to treatment with adrenocorticotropic hormone (ACTH) for West syndrome, and prolonged hypsarrhythmia results in psychomotor deterioration. The evolution to hypsarrhythmia involves conversion of prehypsarrhythmic EEG findings to sporadic hypsarrhythmia paroxysms (HPs), and when paroxysms reach a certain frequency, ISs begin to occur. This retrospective chart study aimed to determine the HP threshold frequency after which ISs begin. Recorded either prior (Group A) or subsequent (Group B) to IS relapse, 248 EEGs were examined in 42 patients. The number of HPs in non-rapid eye movement (NREM) sleep divided by NREM duration constituted the countable hypsarrhythmia paroxysms index (cHPI). After reaching a rate of approximately 10/min, the cHPI lost its feasibility due to the merging of HPs. The durational HPI (dHPI) was also calculated (total duration of HPs during NREM/NREM sleep time×100). ACTH treatment was administered if cHPI was ≥2/min, with the aim of preventing relapse. The mean cHPI value without a concomitant spasm relapse (in Group A) was 1.20/min. Following relapse, this value rose to 4.10/min. EEGs performed subsequent to relapse (in Group B) were classified into ...Continue Reading

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Citations

Mar 3, 2020·Frontiers in Neurology·Jianxiang LiaoLan Xiong
Feb 28, 2019·Entropy·Gean Carlos SousaAllan Kardec Barros
Nov 21, 2020·Journal of Neural Engineering·Colin M McCrimmonBeth A Lopour
Aug 17, 2018·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Daniel W ShreyBeth A Lopour
Jul 10, 2020·Seizure : the Journal of the British Epilepsy Association·A P HamadR M F Fernandes

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