{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:41:45Z","timestamp":1786977705708,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T00:00:00Z","timestamp":1712534400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia Open"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Relapse of epileptic spasms after initial treatment of infantile epileptic spasms syndrome (IESS) is common. However, past studies of small cohorts have inconsistently linked relapse risk to etiology, treatment modality, and EEG features upon response. Using a large single\u2010center IESS cohort, we set out to quantify the risk of epileptic spasms relapse and identify specific risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We identified all children with epileptic spasms at our center using a clinical EEG database. Using the electronic medical record, we confirmed IESS syndrome classification and ascertained treatment, response, time to relapse, etiology, EEG features, and other demographic factors. Relapse\u2010free survival analysis was carried out using Cox proportional hazards regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 599 children with IESS, 197 specifically responded to hormonal therapy and\/or vigabatrin (as opposed to surgery or other second\u2010line treatments). In this study, 41 (21%) subjects exhibited relapse of epileptic spasms within 12\u2009months of response. Longer duration of IESS prior to response (&gt;3\u2009months) was strongly associated with shorter latency to relapse (hazard ratio\u2009=\u20093.11; 95% CI 1.59\u20136.10;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). Relapse was not associated with etiology, developmental status, or any post\u2010treatment EEG feature.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>This study suggests that long duration of IESS before response is the single largest clinical predictor of relapse risk, and therefore underscores the importance of prompt and successful initial treatment. Further study is needed to evaluate candidate biomarkers of epileptic spasms relapse and identify treatments to mitigate this risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain Language Summary<\/jats:title>\n                    <jats:p>Relapse of infantile spasms is common after initially successful treatment. With study of a large group of children with infantile spasms, we determined that relapse is linked to long duration of infantile spasms. In contrast, relapse was not associated with the cause of infantile spasms, developmental measures, or EEG features at the time of initial response. Further study is needed to identify tools to predict impending relapse of infantile spasms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epi4.12931","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T08:45:20Z","timestamp":1712565920000},"page":"1034-1041","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Epileptic spasms relapse is associated with response latency but not conventional attributes of post\u2010treatment\n                    <scp>EEG<\/scp>"],"prefix":"10.1002","volume":"9","author":[{"given":"Emmi","family":"Deckard","sequence":"first","affiliation":[{"name":"Department of Pediatrics Division of Neurology University of California Los Angeles and UCLA Mattel Children's Hospital  California Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rujuta","family":"Sathe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neurology University of California Los Angeles and UCLA Mattel Children's Hospital  California Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Tabibzadeh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neurology University of California Los Angeles and UCLA Mattel Children's Hospital  California Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aria","family":"Terango","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neurology University of California Los Angeles and UCLA Mattel Children's Hospital  California Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aran","family":"Groves","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neurology University of California Los Angeles and UCLA Mattel Children's Hospital  California Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajsekar R.","family":"Rajaraman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neurology University of California Los Angeles and UCLA Mattel Children's Hospital  California Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8318-2924","authenticated-orcid":false,"given":"Hiroki","family":"Nariai","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neurology University of California Los Angeles and UCLA Mattel Children's Hospital  California Los Angeles USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6947-8852","authenticated-orcid":false,"given":"Shaun A.","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Neurology University of California Los Angeles and UCLA Mattel Children's 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Annual Meeting of the American epilepsy Society 2019:2.023."},{"key":"e_1_2_9_24_1","unstructured":"O'CallaghanFJK.Personal communication.2021."},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/WNP.0000000000000886"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10548-017-0588-5"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2018.07.017"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0144732"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2021.106809"}],"container-title":["Epilepsia Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/epi4.12931","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,3]],"date-time":"2024-06-03T08:10:22Z","timestamp":1717402222000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/epi4.12931"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,8]]},"references-count":28,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1002\/epi4.12931"],"URL":"https:\/\/doi.org\/10.1002\/epi4.12931","archive":["Portico"],"relation":{},"ISSN":["2470-9239","2470-9239"],"issn-type":[{"value":"2470-9239","type":"print"},{"value":"2470-9239","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,8]]},"assertion":[{"value":"2023-09-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}