Infantile spasms are also known as West syndrome. The main features are infantile onset, frequent spastic seizures, psychomotor regression, and high amplitude dysrhythmic EEG. 90% of the cases develop within 1 year of age, with a peak incidence at 5 months of life. Etiology: 10%-20% are cryptogenic, the rest are symptomatic, mostly pre-existing various brain lesions: 1, brain developmental malformations: a variety of brain malformations with corpus callosum dysplasia; 2, perinatal brain injury: intrauterine infection, ischemic-hypoxic brain injury, hypoglycemia; 3, neurocutaneous syndrome: tuberous sclerosis, neurofibroma; 4, genetic metabolic diseases, chromosomal aberrations: mitochondrial encephalomyopathy 5, postnatal brain injury: intracranial infection, cerebral hemorrhage clinical manifestations: 4 to 8 months of age onset of the most, the seizure manifested as two arms raised forward, head and trunk forward flexion, like nodding; a few children can show the head backward flexion. The seizures often occur in clusters, and they can easily occur continuously when the child is sleeping or just waking up. Spasmodic seizures last from 3 to 30 months and generally decrease after the age of 1 year, and tend to disappear after the age of 3 years. About half of the children turn to other types of seizures, mostly generalized seizures, including atypical disorientation, tonic seizures, tonic-clonic seizures, atonic seizures, etc. There can also be partial seizures. 23% to 60% of infantile spasms develop into Lennox-Gastaut syndrome. There are five characteristics of infantile spasmodic seizures: 1. nodding individual seizures are short, one seizure is 2-10 seconds, not easy to detect; 2. the whole body, especially the head and upper body flexed forward; 3. nodding seizures are frequent, multiple times a day, each seizure can be consecutive or even dozens of times; 4. the seizure time is usually when just fall asleep or just wake up and consciousness is still in a hazy state, can be accompanied by loss of consciousness, sweating The EEG performance varies during the seizure period, but the interictal period is characterized by peak arrhythmias. EEG: interictal high-amplitude dysrhythmias, rhythmless, asymmetric, asynchronous and chaotic high-amplitude slow-wave backgrounds in the whole brain, mixed spikes and sharp waves in various brain regions. During the seizure phase, the whole brain background wave amplitude is suddenly suppressed based on the total high amplitude slow wave burst pattern, which lasts from 1 second to several seconds. Treatment: Infantile spasms are a kind of intractable epileptic encephalopathy, the most effective treatment plan is still “glucocorticoid + antiepileptic drugs” treatment, glucocorticoid preferred ACTH treatment, about 70% effective, the course of treatment 4-12 weeks, but there are 1/3 of relapses after stopping the drug. Commonly used antiepileptic drugs: aminocaproic acid (Xiborin Vigabatrin), vitamin B6, Toltea, levetiracetam (Kaipuran), valproic acid, clonazepam, lamotrigine. If multiple medications are still ineffective, a ketogenic diet may be an option, and those with focal lesions may have preoperative evaluation for surgical treatment. Prognosis: Most symptomatic infantile spasms have a poor prognosis. Spastic seizures last 3 to 30 months and decrease after 1 year of age. 40% to 60% develop into Lennox ~ Gastaut syndrome or other generalized seizures, including atypical aphasia, tonic seizures, tonic-clonic seizures, atonic seizures, etc. There can also be partial seizures, and most become clinically intractable refractory epilepsy combined with mental retardation.