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

Altunel, Attila; Sever, Ali; Altunel, Emine Özlem

doi:10.1016/j.eplepsyres.2015.01.005

Cited by 13 publications

(21 citation statements)

References 22 publications

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“…Some researchers have shown that even short durations of infantile spasms (in cryptogenic cases as well) can cause brain damage [6]. We have previously displayed the progressively rising HPI prior to the onset of spasms [8] and others associate persistence or long duration of hypsarrhythmia with poor developmental outcome [10,29]. We believe that this level of hypsarrhythmia blocks the generation of sleep spindles.…”

Section: Discussionmentioning

confidence: 79%

“…However, monitoring HPI and preventing the IS-triggering hypsarrhythmia will enable not only favourable treatment outcomes but also more confident outcome predictions. Our recent study [8] and others [32] have used EEG to evaluate treatment response and guide treatment. Although clinical parameters are usually preferred in outcome research on infantile spasms, studies investigating the association between EEG parameters and prognostic outcome are also found in the literature [9,10,12].…”

Section: Discussionmentioning

confidence: 99%

“…Durational HPI (dHPI) was calculated at this point (Table 1). A full description of the method and its evaluation has been published elsewhere [8]. The presence or absence of sleep spindles on EEGs recorded previously at other centers, as well as those on our initial and subsequent recordings were noted.…”

Section: Methodsmentioning

confidence: 99%

“…Additional markers are needed both to guide treatment of WS and to better predict the ensuing neurodevelopmental outcome. Our previous study [8] suggested that the hypsarrhythmia paroxysm index (HPI) could be used as an EEG parameter to guide treatment. Among the outcome parameters studied, lag time and initial response to treatment, age of spasm onset, psychomotor status at presentation, recurrence of spasms, and hypsarrhythmia are the most prominent [3,5,[9][10][11], but the number of studies remains limited.…”

Section: Introductionmentioning

confidence: 99%

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The Utility of the Hypsarrhythmia Paroxysm Index and Sleep Spindles in EEG for Predicting Cognitive Outcomes in a Case Series of Infantile Spasms

Altunel¹,

Eo²,

Sever³

2015

J Neurol Neurophysiol

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Objectives: Among patients with West Syndrome (WS), the underlying brain dysfunction is considered to be the major determinant of cognitive outcome. However, regardless of whether the WS type is symptomatic or cryptogenic, patients with infantile spasms may have a favourable or grim prognosis. The purpose of this study was to utilize electroencephalography (EEG) to guide treatment, and to assess cognitive outcome. Methods: We retrospectively reviewed the clinical and sleep EEG data in 16 patients who received adrenocorticotropic hormonal therapy between 2002 and 2014. The hypsarrhythmia paroxysm index (HPI), the frequency or duration of hypsarrhythmia paroxysms in non-rapid eye movement (NREM) sleep, and sleep spindles were evaluated in groups constituted according to etiology. Results: Cryptogenic patients whose onset of spasms began after 3 months of age and who experienced a shorter treatment delay had preserved spindles and favourable cognitive outcomes. Sleep spindles disappeared in cryptogenic patients with an early onset of spasms, long treatment delay, and high HPI at referral; their neurodevelopmental prognosis was unfavourable. In symptomatic cases in which the age of onset of spasms was earlier than 3 months and there had been a short treatment delay, sleep spindles never fully evolved, and the prognosis was poor. Patients with corpus callosum hypogenesis, a relatively mild malformation, had high HPI values at referral. While two of these patients did not display spindles during the follow-up, three had reappearing spindles as HPI values diminished, and the outcome was less severe in these patients. Conclusion: This study highlights the significance of EEG in studies of the prognosis of infantile spasms and demonstrates an objective approach that utilizes concurrent evaluation of sleep spindles and HPI.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Utility of the Hypsarrhythmia Paroxysm Index and Sleep Spindles in EEG for Predicting Cognitive Outcomes in a Case Series of Infantile Spasms

Altunel¹,

Eo²,

Sever³

2015

J Neurol Neurophysiol

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“…The Congenital Zika Virus Infection can cause severe brain abnormalities and diverse electroencephalographic abnormalities [ 1 ]. Among these is hypsarrhythmia, an unusual activity of the electroencephalogram (EEG), found in a few types of epilepsy and known for interictal and spike-and-wave discharges in an irregular and disorganized background [ 2 , 3 , 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Identification of Hypsarrhythmia in Children with Microcephaly Infected by Zika Virus

Sousa

Queiroz

Sousa

et al. 2019

Entropy

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Hypsarrhythmia is an electroencephalographic pattern specific to some epileptic syndromes that affect children under one year of age. The identification of this pattern, in some cases, causes disagreements between experts, which is worrisome since an inaccurate diagnosis can bring complications to the infant. Despite the difficulties in visually identifying hypsarrhythmia, options of computerized assistance are scarce. Aiming to collaborate with the recognition of this electropathological pattern, we propose in this paper a mathematical index that can help electroencephalography experts to identify hypsarrhythmia. We performed hypothesis tests that indicated significant differences in the groups under analysis, where the p-values were found to be extremely small.

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Strength and stability of EEG functional connectivity predict treatment response in infants with epileptic spasms

Shrey

McManus

Rajaraman

et al. 2018

Clinical Neurophysiology

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

Cited by 13 publications

References 22 publications

The Utility of the Hypsarrhythmia Paroxysm Index and Sleep Spindles in EEG for Predicting Cognitive Outcomes in a Case Series of Infantile Spasms

The Utility of the Hypsarrhythmia Paroxysm Index and Sleep Spindles in EEG for Predicting Cognitive Outcomes in a Case Series of Infantile Spasms

Identification of Hypsarrhythmia in Children with Microcephaly Infected by Zika Virus

Strength and stability of EEG functional connectivity predict treatment response in infants with epileptic spasms

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