Study On The TCM Epilepsy Syndrome Classification Of Infantile Spasms And Its Relationship With EEG And Prognosis

Objective:To study on the infantile spasms (IS) of Traditional Chinese Medicine (TCM) epilepsy syndrome classification and its relationship with EEG and prognosis.Methods:With certain diagnosis criteria, inclusion criteria, exclusion criteria, and mainly with interview and physical examination we collected100cases of consecutive patients with infantile spasms at Shenzhen Children’s Hospital. The investigation was specifically designed for TCM diagnosis and classification of infantile spasms. Video-electroencephalograms (V-EEG) for2-3hours including both wakefulness and sleep were recorded, synchronized with video monitoring of clinical spasms. The19scalp electrodes were applied according to the international10-20system. Referenced to the ears, one channel of electrocardiogram was included. Digitally recorded EEG traces were reviewed on EEG work station or printed on papers for the subsequent analysis. And all the cases were followed up for1-2years.Results:The TCM epilepsy syndrome classification of infantile spasms was investigated. The frequency distribution from more to less order was:deficiency of the liver and kidney type, sputum epilepsy type, blood stasis type, and panic epilepsy type. In100cases of IS children, there were53cases with the EEG background of classical hypsarrhythmia before treatment, with non-classical (modified) hypsarrhythmia in23cases, focal abnormality of background were in24cases. There is a certain relationship between every syndrome type and electroencephalogram. But the relationship is not strong(rp=0.372).The short-term outcome of seizure control after the standard treatment showed statistical difference among four types of TCM epilepsy syndromes of infantile spasms (P<0.01), deficiency of the liver and kidney type v.s. sputum epilepsy type had significant difference (P<0.01); deficiency of the liver and kidney type v.s. panic epilepsy type had significant difference (P<0.01); blood stasis type v.s. sputum epilepsy type had significant difference (P<0.05). There was no significant difference in prognosis between other types of TCM epilepsy syndromes (P>0.05).Conclusion:The major type of TCM syndrome in infantile spasms was that of deficiency of the liver and kidney, secondly were sputum epilepsy type, blood stasis type, and panic epilepsy type. The type of TCM syndrome in infantile spasms and the anomalies of EEG had some correlation. The major EEG background of deficiency of the liver and kidney type and blood stasis type were non-classical (modified) hypsarrhythmia and focal abnormality of the background. However, the major EEG interictal background of sputum epilepsy type and panic epilepsy type were classical hypsarrhythmia. Patients with infantile spasms had poor prognosis. The majority of patients had varying degrees of psychomotor retardation. Among various TCM syndromes in infantile spasms, deficiency of the liver and kidney type and blood stasis type had poorer prognosis, and sputum epilepsy type and panic epilepsy type had better prognosis than that of deficiency of the liver and kidney type and blood stasis type.