Of 45 infants having epileptic discharges on the EEG in early infancy, 26 developed West syndrome (WS), in a study at Okayama University, Japan. Infants with periventricular leukomalacia (PVL) were more likely to develop WS than those without; they were also more likely to have WS than other types of epilepsy. Eleven out of 17 infants with PVL developed WS. Most infants with WS had developed initial epileptic discharges before 3 months of age. Preterm infants with PVL who show epileptic discharges on EEG before 3 months of age should receive antiepileptic treatment to prevent the onset of WS. [1]

COMMENT. A new model of flexion spasms involving prenatal exposure to betamethasone followed by injection of N-methyl-D-aspartic acid (NMDA) on day 15 postnatally in rats may provide a means of development and testing of new effective therapies for infantile spasms [2, 3]. These experimental spasms were sensitive to-ACTH therapy, ictal EEG electrodecremental or afterdischarges compatible with hypsarrhythmia were recorded, and imaging studies defined lesions in the limbic areas, hypothalamus, and brainstem associated with spasms.