Prognosis

In general the prognosis is poor.

• poor development is likely to be seen in IS associated with underlying genetic and structural brain issues, regardless of treatment
• normal or near normal development is present in only 15-25%
• epilepsy is present in up to 50% of patients
• autism is present in 15-33% of patients with infantile spasms and as high as 70% patients with tuberous sclerosis and infantile spasms

Aetiology is considered to be the most important predictor of outcome. Better development outcomes are observed in:

• patients without an identified etiology (cryptogenic/idiopathic)
• those treated with hormonal therapy rather than vigabatrin
• short treatment lag (<1 month) especially among cryptogenic patients

Normal or near normal outcomes are seen in 54.3% of the cases with cryptogenic IS while only 12.5% of symptomatic patients have a good outcome

Mortality of the condition:

• may be as high as 10% at 3 years of age
• 19% at age 10 years (1).

Reference:

• (1) Nelson GR. Management of infantile spasms. Transl Pediatr. 2015;4(4):260-70.