Comparison of Pre- and Post-Therapy Cortical Excitability Using Transcranial Magnetic Stimulation in Children with West Syndrome: A Longitudinal Study

What this Trial Is About

Researchers are studying cortical excitability in children with West Syndrome, a unique epilepsy syndrome characterized by infantile onset epilepsy and significant neurodevelopmental delay. This study aims to understand how cortical excitability relates to disease activity and whether it can predict response to ACTH therapy by measuring changes before and after treatment. The research seeks to generate new insights into seizure pathogenesis, individualized antiepileptic therapy, and treatment response in childhood epilepsy. The study involves children aged 6 months to 2 years diagnosed with West Syndrome. Participants will undergo initial evaluation, including history, clinical examination, and necessary investigations such as MRI and vitamin trials. Those eligible will receive high-dose ACTH therapy for 6 weeks, with doses tapered after 2 weeks. Children with less than 50% spasm reduction may start ketogenic diet therapy under supervision or choose other treatment options. Transcranial Magnetic Stimulation (TMS) and EEG will be performed at baseline, 6 weeks, and 3 months to assess cortical excitability and treatment effects. During the study, participants will have regular follow-ups at 6 weeks, 8 weeks, and monthly up to 6 months when feasible. Researchers will monitor seizure frequency, adverse events, treatment compliance, and neurodevelopmental assessments. Outcome measures include changes in cortical excitability at 12 weeks and spasm reduction rates. Investigations and therapies related to the study will be provided at no cost. Parents will give informed consent and can withdraw their child anytime without affecting future care.

Cortical Excitability in West Syndrome Using Transcranial Magnetic Stimulation