Infantile spasms are also known as West syndrome. The main features are infantile onset, frequent spastic seizures, regression of psychomotor development, and high amplitude dysrhythmias (hypsarrhythmia) 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, and the rest are symptomatic, with various brain lesions existing before the disease. 1, developmental malformations of the brain: a variety of brain malformations with callosal dysplasia; 2, perinatal brain injury: intrauterine infection, ischemic-hypoxic brain injury, hypoglycemia; 3, neurocutaneous syndrome: tuberous sclerosis, neurofibroma; 4, genetic metabolic disease, chromosomal aberrations: mitochondrial encephalomyopathy; 5, postnatal brain injury: intracranial infection, cerebral hemorrhage clinical manifestations: 4 to 8 months of age onset of the most people, the onset of The seizures are characterized by the raising of the arms, the forward flexion of the head and trunk, and the nodding of the head; a small number of children may show a backward flexion of the head. 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 change 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 easily detected; 2. the whole body, especially the head and upper body, is 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 you 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 mostly characterized by peak arrhythmia. EEG: Interictal high-amplitude dysrhythmias, rhythmless, asymmetric, asynchronous and chaotic high-amplitude slow wave background in the whole brain, mixed spikes and sharp waves in various brain regions. During the seizure, the whole brain background is suddenly suppressed for 1 to several seconds on the basis of a total high-amplitude slow wave burst pattern. Treatment: Infantile spasms is a refractory epileptic encephalopathy, the most effective treatment plan is still “glucocorticoids + antiepileptic drugs” treatment, glucocorticoids preferred ACTH treatment, about 70% effective, the course of treatment 4-12 weeks, but there is 1/3 of the relapse after discontinuation of drugs. 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, and atonic seizures, etc. There can also be partial seizures, and most become clinically intractable refractory epilepsy combined with mental retardation.