Infantile spasticity is also known as West syndrome. I. Etiology Infantile spasms can be categorized etiologically into symptomatic and cryptogenic. The etiology of symptomatic West syndrome is diverse, including perinatal factors, cerebral cortical developmental abnormalities, metabolic disorders, central nervous system infections, and vascular diseases. Zhang Hua, Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University In recent years, with the development of high-resolution MRI, it has been found that cortical developmental abnormalities play an important role in the etiology of infantile spasticity. 63% of patients have cortical developmental disorders due to a variety of causes, including developmental disorders due to neonatal injuries and tuberous sclerosis, etc. 10-20% of infantile spasticity is due to tuberous sclerosis, and other Other cortical developmental abnormalities, such as lissencephaly, multiple cerebellar gyrus, and focal cortical dysplasia, are also important causes of infantile spasticity. Diagnosis 1, spasticity seizures, including flexor type, extensor type and mixed type, the typical seizure manifests as nodding head, embracing movement of both upper limbs, mostly in strings of seizures; 2, electroencephalogram shows high dysrhythmia, which manifests as disordered rhythms, irregular amplitude of waves, asymmetric synchronization of bilateral and irregularity; 3, psychomotor developmental retardation. Third, non-surgical treatment Infantile spasms are categorized as drug-refractory epilepsy syndromes, and drug treatment is tricky. The drugs of choice include hormone therapy (including ACTH and steroids) and aminoglycolic acid. Other medications used for infantile spasms include sodium valproate, clonazepam, levetiracetam, topiramate, and lamotrigine. Some children also have significant results for the ketogenic diet. Fourth, surgical treatment Infantile spasms medication is difficult, frequent seizures, daily clinical seizures can reach dozens of times to hundreds of times, the impact on the child’s brain development and cognitive level, more than 90% of the presence of psychomotor retardation, so suitable for surgery should be active early surgery to avoid the impact of intelligence and cognitive deterioration. (I) Timing of surgery and patient selection 1, drug treatment Hormone therapy and aminoglycolic acid treatment is still necessary, due to the lack of aminoglycolic acid in China, another 1-2 epileptic drugs can be selected, and ineffective preoperative evaluation is considered. 2.Patient intelligence and cognitive level The presence of psychomotor retardation or deterioration along with ineffective drug therapy is an important indicator for surgical intervention. (ii) Preoperative assessment 1. Clinical history and physical examination for definite lateral localization of manifestations; 2. Origin of EEG during seizures; 3. Structural abnormalities on neuroimaging; 4. Abnormalities on functional assessment of PET. (iii) Surgical approach Surgical treatment for infantile spasms mainly includes two surgical approaches: radical and palliative. For those who have a clear cause and the epileptic foci are limited and located in non-functional areas, resective surgery (radical surgery) is adopted; for those who do not have a clear cause or the discharges are widespread and diffuse, palliative surgery can be adopted, and the surgical modalities mainly include corpus callosotomy and vagus nerve stimulation.