Background:Few papers address the comprehensive prognosis in infantile spasms and look into the seizure profile and psychomotor outcome.Objective:We aimed to follow up children with infantile spasms to study: a) the etiology, demographics, semiology, electroencephalogram (EEG), and radiological pattern; b) seizure control, psychomotor development, and EEG resolution with treatment; c) the effects of various factors on the control of spasms, resolution of EEG changes, and psychomotor development at 3-year follow-up.Materials and Methods:Fifty newly diagnosed cases with a 1-12 month age of onset and who had hypsarrhythmia in their EEG were recruited and 43 were followed up for 3 years.Results:Of the children followed up, 51% were seizure-free and 37% had a normal EEG at the 3-year follow-up. Autistic features were seen in 74% of the children. Only 22.7% among the seizure-free (11.6% of the total) children had normal vision and hearing, speech with narration, writing skills, gross and fine motor development, and no autism or hyperactivity. On multivariate analysis, two factors could predict bad seizure outcome — the occurrence of other seizures in addition to infantile spasms and no response to 28 days of adrenocorticotropic hormone (ACTH). No predictor could be identified for abnormal psychomotor development.Discussion and Conclusion:In our study, we could demonstrate two factors that predict seizure freedom. The cognitive outcome and seizure control in this group of children are comparable to the existing literature. However, the cognitive outcome revealed by our study and the survey of the literature are discouraging.

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Purpose:Infantile spasms are described as flexor extensor and mixed; but more features of their semiology and ictal electroencephalography (EEG) changes are sparse in the literature. The purpose of the study was to describe the clinical and ictal video-EEG characteristics of consecutive cases with infantile spasms and to try to find an association with the etiology.Materials and Methods:The clinical phenomenology and EEG characteristics on video-EEG were analyzed in 16 babies with infantile spasms.Results:A total of 869 spasms were reviewed. Nine (56.3%) showed focal seizures at least once during the recording and 1 (6.3%) had multifocal myoclonus in addition to the spasms. The duration of the cluster and interval between spasms was totally variable in all patients. Lateralizing phenomena were present in at least some of the spasms in all patients. Unilateral manual automatism in the form of holding the pinna was noted in three patients following the spasm. The ictal EEG activity in the majority (75%) was the slow wave. Four (25%) showed fast generalized spindle-like ictal discharges. Spikes, spike and wave activity, or electrodecremental pattern alone during the ictus was seen in none. On bivariate analysis, no factor noted on the video EEG had association with the etiology.Conclusion:Infantile spasms could be associated with focal and other seizures, has unique, non-uniform and variable semiology from patient to patient. The ictal EEG manifestation in the majority (75%) of our patients was the slow wave transient with 25% showing generalized fast spindle-like activity.

To evaluate the effectiveness of mirror therapy on upper extremity motor recovery and hand related functioning of patients with sub-acute stroke. MethodA total of 60 patients with stroke were randomly selected, all within 6 months post stroke, with 30 patients in each, experimental and control group. Each day, 30 min of mirror therapy was given to patients in experimental group consisting of wrist and finger flexion and extension movements in addition to conventional stroke rehabilitation program, 6 days a week, 1 h a day for 4 weeks, while those in control group didn't receive mirror therapy program. Main Outcome Measures-The Brunnstrom stages of motor recovery & Hand-related functioning (Self-care items of FIM instrument) ResultsMean age of the patients was 55 years. The scores of the Brunnstrom stages for hand and upper extremity and FIM self -care score improved more in experimental group than in control group after 4 weeks of treatment (by 0.81, 0.86 and 4.1 respectively; all P b .05) and at 6 month follow -up (by 0.18, 0.51and 2.52 respectively^; all P b .05) ConclusionHand functioning improved more after mirror therapy compared with control group after 4 weeks of treatment and at 6 month follow up.

Free papers 03 -CNS infectionsEtiology and short term outcome of acute febrile encephalopathy among children in a tertiary care centre in South India