Research Update – Dr. Miguel Cortez

Infantile spasms (IS) occur in 0.2-0.5 cases for every 1000 live births around the world, and are identified as sudden limb movements caused by seizures. Children with IS show these movements in the first year of life. IS are more likely to occur in children with a brain injury or brain tumour from tuberous sclerosis complex, a severe genetic disorder. If treatment is not provided early enough, children with IS may develop cognitive impairments including problems with memory, attention, or language. A greater understanding of the risk factors associated with IS may help prevent their onset. In a review by Dr. Miguel Cortez and colleagues, they report on the incidence and prevalence of IS in different geographical locations and investigate potential risk factors that may influence the development of IS. The authors defined incidence as the number of patients diagnosed with IS during the observed study period, and defined prevalence as the number of patients with active symptoms (i.e. seizures) of IS during the study period.

To gather reports on IS incidence and prevalence from 1946-2016, Dr. Cortez and colleagues conducted an extensive research review using multiple international databases. From the database searches, the researchers found 54 scientific articles reporting either IS incidence or prevalence from all continents except South America, Africa, and Oceania. The study found that for every 100,000 babies born during the study period, 25 were diagnosed with IS, and for every 100,000 people in a population, 1.5 had active symptoms of IS.

Another analysis revealed that the highest incidence of IS was in Europe, and particularly in Sweden, Denmark, Finland, and Iceland. Dr. Cortez and colleagues wondered if the high incidence of IS in these Scandinavian countries was due to local health care systems that could detect and diagnose IS more efficiently. However, they did not find any link between the incidence of IS and measures of healthcare quality, such as healthcare spending or number of physicians. Compared to Europe, there was a lower onset of IS in Asia and North America.

Overall, the results show geographical differences and an environmental effect on the prevalence and incidence of IS. More geographical information is needed on IS incidence and prevalence in the Southern hemisphere to determine whether a comparable latitudinal effect exists. The epidemiology also suggests that some people may be more likely to have seizures if they have high melatonin and low Vitamin D3 levels. This is supported by prior studies revealing changes to melatonin or Vitamin D3 levels linked to abnormal brain activity and increased risk of seizures. However, additional studies are needed to confirm this. To further clarify risk factors of IS, Dr. Cortez advocates for the creation of a global IS registry to identify which individuals and populations are at greatest risk of developing IS.

For the full article see this link: https://rdcu.be/bb7w1

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