{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:41:15Z","timestamp":1792798875597,"version":"4.5.0"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuropediatrics"],"abstract":"<jats:p>Objective: To analyse the etiological spectrum, safety and effectiveness of first-line agents and developmental outcomes of children with Infantile Epileptic Spasms Syndrome (IESS) managed at a tertiary-care hospital in South India, focusing on the influence of lead time to treatment.\nMethods: This retrospective cohort study included 65 children diagnosed with IESS between 2020 and 2025. Lead time to treatment was categorized as \u22641 week, 1\u20132, 3\u20138, and &gt;8 weeks. First-line therapies included high-dose oral corticosteroids, vigabatrin, or sequential therapy. Treatment response was assessed at one and three months and developmental outcomes at follow-up.\nResults: The median age at onset of spasms was 6 months (IQR 5,8) and the median treatment lag 4 weeks (IQR 1,12) with only 26% treated within the first week. Structural-acquired etiologies predominated (36\/65; 55.3%), commonly periventricular leukomalacia (24.6%) and neonatal hypoglycaemic brain injury (13.8%). Spasm cessation occurred in 62% at one month and was sustained in 55.4% at three months, with a relapse rate of 15.4%. High-dose oral corticosteroids achieved a significantly higher one-month response than vigabatrin or sequential therapy (p = 0.006).  Earlier treatment showed numerically better responses without statistical significance. Adverse effects occurred in 48%, most commonly irritability (64.5%) and weight gain (22.5%). At a mean follow-up of 19.4 months, approximately one-third of children achieved normal or borderline developmental outcomes.\nConclusion: Structural-acquired etiologies predominated, and lead time did not significantly influence treatment response. Our findings support that high-dose oral corticosteroids appear to be an effective, practical, and reasonably safe first-line therapy for IESS in resource-limited settings<\/jats:p>","DOI":"10.1055\/a-2987-4550","type":"journal-article","created":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:07:46Z","timestamp":1792796866000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of etiology and lead time to treatment with first-line agents on outcome of infantile epileptic spasms syndrome-A retrospective cohort from LMIC"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2943-1990","authenticated-orcid":false,"given":"SHRAVANI","family":"GK","sequence":"additional","affiliation":[{"name":"Manipal Hospital Old Airport Road, Karnataka, India","place":["Bengaluru"],"department":["Department of Paediatric Neurology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9972-0774","authenticated-orcid":false,"given":"Bidisha","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Manipal Hospital Old Airport Road, India","place":["Bangalore"],"department":["Pediatrics (Neurology)"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ullas V","family":"Acharya","sequence":"additional","affiliation":[{"name":"Manipal Hospital Old Airport Road, India","place":["Bangalore"],"department":["Neuroradiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitesh","family":"Shetty","sequence":"additional","affiliation":[{"name":"Manipal Hospital Old Airport Road, KA, India","place":["Bengaluru"],"department":["Department of Medical Genetics,"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","container-title":["Neuropediatrics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2987-4550.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:07:47Z","timestamp":1792796867000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2987-4550"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,23]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1055\/a-2987-4550","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0174-304X","1439-1899"],"issn-type":[{"value":"0174-304X","type":"print"},{"value":"1439-1899","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10,23]]},"published":{"date-parts":[[2026,10,23]]}}}