Folia Psychiatrica et Neurologica Japonica, Vol. 32, No. 3, 1978
CT Findings of Infantile Spasms Noriaki Shinomiya, M.D.and Tugutoshi Aoki, M.D. Department of Pediatrics, Toho University School of Medicine, Tokyo
INTRODUCTION
RESULT AND DISCUSSION
The importance of brain computed tomography ( C T ) in the diagnosis of diseases of the central nervous system has been evaluated. A number of reports on the CT examinations of patients with epilepsies has revealed its usefulness in the analysis of pathophysiology and treatment of the disorder, The authors have performed brain CT scans on more than 150 children with convulsive disorders. This report is a summary of results concerned with infantile spasms and Lennox-Gastaut Syndrome.
CT findings in the 16 patients are listed in Table 1. The main findings from CT scans of infantile spasm patients were cortical atrophies at the frontal, temporal and inferior parietal lobe, with Sylvian fissure dilatation and central sulcus dilatation. In contrast to the previous report,' ventricular dilatations in our series were observed in only three cases, cyst of the corpos callosum, cogenital rubella syndrome and one case with Lennox-Gastaut Syndrome. In one of our cases, the abnormal low density at the rt-side unilateral frontal lobe was observed. But the typical CT findings in infantile spasms are as in Fig. 1. In the previous neuropathological examinations of autopsied cases with infantile spasms,2 the main pathology was observed in the thalamus, the basal ganglia, the tectum and the frontal lobe. Our findings
MATERIALS AND METHOD CT scans were performed on in- and out-patients among children with infantile spasms and with Lennox-Gastaut Syndromes, 13 and three cases respectively, within five months from May to October, 1977. The ages of the patients ranged from six months to 1 1 years old. Diagnoses were confirmed by characteristic clinical signs of seizure and EEG patterns. All were considered as idiopathic, excepting three cases, which were diagnosed as Down Syndrome, cogenital rubella syndrome and cyst at the anterior part of the corpos callosum. Brain CT scans consisted of four transverse scans obtained at 2 cm intervals taken in a 15' O-M plane.
Received for publication Apr. 30, 1978.
Table 1 : Brain CT Scan Findings of Infantile Spasms Cortical Atrophy Frontal lobe atrophy Parietal lobe atrophy Central sulcus dilatation Temporal lobe atrophy Sylvian fissure dilatation Other lobe atrophy Ventricular Dilatation Abnormal Density
15/16
14/13 10/16 10/16 15/16
15/16 3/16 3/16 3/16
394
N. Shinomiya and T. Aoki
Fig. 1: Typical CT finding in infantile spasms. Enlargement of Sylvian and central sulci and frontal lobe atrophy are remarkable.
of CT scans were well compatible with these pathological features. It is interesting that in some cases, in which brain atrophy had been deteced by pneumoencephalography several years before, normal CT scan was revealed. This suggested the necessity of serial CT-examinations to evaluate the natures of the findings-whether they were reversible or irreversible, functional or organic.
REFERENCES Okuno, T., Hojo, H.,Okuda, R., Nakano, Y. and Handa, J.: Computed tomography in children, Nervous system in children, 2: 197-204, 1977. 2 Morimatsu, Y.,Murofushi, K., Handa, T.,
Shinohara, T. and Shiraki, H.:Pathological studies of severe physically and mentally handicapped-with special reference to four cases of infantile spasms, advances in neurological science, 10: 465-476, 1972.
CT Findings of Infantile Spasms Noriaki Shinomiya, M.D.and Tugutoshi Aoki, M.D. Department of Pediatrics, Toho University School of Medicine, Tokyo
INTRODUCTION
RESULT AND DISCUSSION
The importance of brain computed tomography ( C T ) in the diagnosis of diseases of the central nervous system has been evaluated. A number of reports on the CT examinations of patients with epilepsies has revealed its usefulness in the analysis of pathophysiology and treatment of the disorder, The authors have performed brain CT scans on more than 150 children with convulsive disorders. This report is a summary of results concerned with infantile spasms and Lennox-Gastaut Syndrome.
CT findings in the 16 patients are listed in Table 1. The main findings from CT scans of infantile spasm patients were cortical atrophies at the frontal, temporal and inferior parietal lobe, with Sylvian fissure dilatation and central sulcus dilatation. In contrast to the previous report,' ventricular dilatations in our series were observed in only three cases, cyst of the corpos callosum, cogenital rubella syndrome and one case with Lennox-Gastaut Syndrome. In one of our cases, the abnormal low density at the rt-side unilateral frontal lobe was observed. But the typical CT findings in infantile spasms are as in Fig. 1. In the previous neuropathological examinations of autopsied cases with infantile spasms,2 the main pathology was observed in the thalamus, the basal ganglia, the tectum and the frontal lobe. Our findings
MATERIALS AND METHOD CT scans were performed on in- and out-patients among children with infantile spasms and with Lennox-Gastaut Syndromes, 13 and three cases respectively, within five months from May to October, 1977. The ages of the patients ranged from six months to 1 1 years old. Diagnoses were confirmed by characteristic clinical signs of seizure and EEG patterns. All were considered as idiopathic, excepting three cases, which were diagnosed as Down Syndrome, cogenital rubella syndrome and cyst at the anterior part of the corpos callosum. Brain CT scans consisted of four transverse scans obtained at 2 cm intervals taken in a 15' O-M plane.
Received for publication Apr. 30, 1978.
Table 1 : Brain CT Scan Findings of Infantile Spasms Cortical Atrophy Frontal lobe atrophy Parietal lobe atrophy Central sulcus dilatation Temporal lobe atrophy Sylvian fissure dilatation Other lobe atrophy Ventricular Dilatation Abnormal Density
15/16
14/13 10/16 10/16 15/16
15/16 3/16 3/16 3/16
394
N. Shinomiya and T. Aoki
Fig. 1: Typical CT finding in infantile spasms. Enlargement of Sylvian and central sulci and frontal lobe atrophy are remarkable.
of CT scans were well compatible with these pathological features. It is interesting that in some cases, in which brain atrophy had been deteced by pneumoencephalography several years before, normal CT scan was revealed. This suggested the necessity of serial CT-examinations to evaluate the natures of the findings-whether they were reversible or irreversible, functional or organic.
REFERENCES Okuno, T., Hojo, H.,Okuda, R., Nakano, Y. and Handa, J.: Computed tomography in children, Nervous system in children, 2: 197-204, 1977. 2 Morimatsu, Y.,Murofushi, K., Handa, T.,
Shinohara, T. and Shiraki, H.:Pathological studies of severe physically and mentally handicapped-with special reference to four cases of infantile spasms, advances in neurological science, 10: 465-476, 1972.
