How are infantile spasms (IS) diagnosed?

Shaun A. Hussain, MD
To make a definitive diagnosis of infantile spasms, doctors need to do something called video electroencephalography, or video EEG. This is basically two tests in one. It is simultaneous video and EEG. EEG involves attaching about 20 electrodes attached to the scalp with a temporary glue, in order to monitor brain waves. Doctors are specifically looking for seizures, which are the spasms, as well as hypsarrhythmia and several variants of hypsarrhythmia.

Doctors will often use the term "differential diagnosis," and this refers to figuring out that behaviors or something that the parents are worried about aren't actually seizures or infantile spasms. Doctors watch for reflux. Infants can have the same heartburn that adults have, and when they get heartburn, they often have movements that resemble infantile spasms. There are also a lot of normal movements that happen in sleep, and as many of us know, babies do lots of weird movements that are within the spectrum of normal, and we call those "behavioral."

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