doiSerbia

Evaluation of psycho-motor development in children with West syndrome

Nikolić Dimitrije (Univerzitetska dečja klinika, Beograd + Medicinski fakultet, Beograd)
Ivanovski Petar (Univerzitetska dečja klinika, Beograd + Medicinski fakultet, Beograd)
Bogićević Dragana (Univerzitetska dečja klinika, Beograd + Medicinski fakultet, Beograd)
Dimitrijević Nikola (Univerzitetska dečja klinika, Beograd)
Milovanović Ivan (Institut za patološku fiziologiju, Medicinski fakultet, Beograd)
Purić Selena (Univerzitetska dečja klinika, Beograd)
Delić Jovanka (Medicinski fakultet, Beograd)
Mihailović-Stanojević Nevena (Institut za medicinska istraživanja, Beograd)

Introduction. West Syndrome (WS) is age-related epileptic encephalopathy characterised by a triad of symptoms: specific seizure type, pathognomonic electroencephalographic (EEG) pattern - hypsarrhythmia and delay and/or regression in psychomotor development (PMD). Aetiologically, it occurs in three forms: symptomatic, cryptogenic and idiopathic. Objective. Estimation of PMD in children with WS according to aetiology. Methods. The observed group consisted of 65 children. Age range was between 6 and 30 months. The patients were divided into three groups according to aetiology. All patients underwent psychological examination with Brunet-Lesine test, as well as PMD evaluation based on achieved developmental milestones for the corresponding age. Results. Statistically significant better values in the Human Developmental Index (HDI) had patients with idiopathic compared to other forms of WS, at testing after 12 months (93.0±8.1 vs. 46.8±6.1 vs. 45.6±3.8), as well as after 24 months (93.9±7.7 vs. 51.9±5.5 vs. 50.9±4.4). The best values of HDI after 24 months had patients with improvement in PMD with the average of 66.2±4.4, which was statistically significant compared to those with unchanged PMD (41.5±5.3) and with further regression in PMD (28.3±4.4). Significant correlation was obtained between PMD after 12 and 24 months (r=0.477), as well as a considerable improvement in HDI from the 12th to 24th month (49.4±4.0 vs. 53.7±3.9). Conclusion. The patients with idiopathic WS accomplished the best PMD. Improvement in PMD after 12 and 24 months of treatment was associated with improved HDI. Improvement in PMD was observed in all patients after 2 years of follow-up.

Keywords: West syndrome, psychomotor development, psychological testing, Human Developmental Index