Salaam spasms

Salaam Spasms are a type of seizure observed in infants and young children, characterized by a sudden, forward flexing of the head, arms, and waist, resembling a bowing or salaam gesture. These seizures are a hallmark of a severe epileptic syndrome known as Infantile Spasms (IS) or West Syndrome. Salaam spasms typically manifest in children between the ages of 3 months and 2 years, with a peak incidence around 4 to 8 months of age.

Etiology

The exact cause of Salaam spasms is not fully understood, but they are associated with a variety of conditions that affect brain development. These can include genetic disorders, structural abnormalities of the brain, and metabolic diseases. In some cases, the cause remains unknown, which is referred to as cryptogenic.

Symptoms

Salaam spasms are characterized by brief, symmetric, muscular contractions that last for one to two seconds. These contractions cause the child to bend forward at the waist while extending the arms outward. The spasms often occur in clusters, with each cluster lasting for several minutes. They are more likely to occur upon waking or during periods of drowsiness.

Diagnosis

Diagnosis of Salaam spasms involves a combination of clinical observation and diagnostic tests. The Electroencephalogram (EEG) is a critical tool, often revealing a chaotic, disorganized pattern known as hypsarrhythmia, which is indicative of infantile spasms. Neuroimaging, such as Magnetic Resonance Imaging (MRI), may also be used to identify any underlying brain abnormalities.

Treatment

Treatment for Salaam spasms aims to control the seizures and address any underlying conditions. First-line treatments typically include adrenocorticotropic hormone (ACTH) or vigabatrin. Other antiepileptic drugs may also be used, depending on the child's response to initial treatments. Early intervention is crucial to improve developmental outcomes.

Prognosis

The prognosis for children with Salaam spasms varies widely and largely depends on the underlying cause. Children with cryptogenic spasms generally have a better prognosis than those with symptomatic spasms. Early and effective treatment can significantly improve the outlook, though some children may continue to experience developmental delays or other types of seizures.

See Also

• Epilepsy
• Pediatric Neurology
• Seizure Disorders