COVID-19 in Children with West Syndrome: An Ambispective Study

Abstract

ObjectivesTo study the course of West syndrome (WS) and coronavirus disease-19 in children with WS who contracted SARS-CoV-2 infection. Methods This ambispective study was conducted at a tertiary-care center in North India between December 2020 and August 2021 after approval from the Institute Ethics Committee. Five children with WS, positive for COVID-19 based on RT-PCR, fulfilled the inclusion criteria. Results One child with COVID-19 during the first wave was retrospectively included while four children (of the 70 children screened) were prospectively enrolled. The median age at onset of epileptic spasms was 7 mo (2 boys), and that at presentation with COVID-19 was 18.5 mo. Three had underlying acquired structural etiology. Three were in remission following standard therapy, while two had ongoing spasms at the time of COVID-19 illness. During the illness, two of those in remission continued to be in remission while one child had a relapse. The children with ongoing epileptic spasms had variable course [one had persistent spasms and other had transient cessation lasting 3 wk from day 2 of COVID-19 illness, but electroencephalography (on day 8 of COVID-19 illness) continued to show hypsarrhythmia]. Fever was the most typical symptom (and sometimes the only symptom) of COVID-19, with a duration ranging from 1-8 d. Two children had moderate COVID-19 illness requiring hospitalization, while the rest had a mild illness. All the affected children had complete recovery from COVID-19. ConclusionThe severity of COVID-19 illness in children with WS is often mild, while the subsequent course of WS is variable.

Acute disseminated encephalomyelitis and viral encephalitis: An unusual and misleading imaging

“…ADEM has been extensively described in pediatric population with similar MRI findings as adults. [6][7][8] ANEC is mainly seen in children with bilateral symmetrical thalamic lesions. Serum lactate was normal in our case; hence possibility of mitochondrial disease was low.…”

“…AHL, AHEM, and acute necrotizing hemorrhagic leukoencephalitis (ANHLE) of Weston Hurst are different variants of acute, rapidly progressive, and frequently fulminant inflammatory hemorrhagic demyelination of CNS white matter. [8][9][10][11][12][13][14] Death from brain edema is common within 1 week of onset of encephalopathy. There can be favorable outcomes with early and aggressive treatment with combination of corticosteroids, immunoglobulins, cyclophosphamide, and therapeutic plasma exchange.…”

Impact of COVID-19 Infection in West Syndrome: The Need for More Data

“…The study by Madaan et al provides insight into the impact of COVID-19 infection among five children treated for WS [ 4 ]. The study included three children with West syndrome who were in remission (one with structural etiology, one with tuberous sclerosis, and one with presumed genetic etiology) and two with persistent spasm (both had structural etiology).…”