[Cerebral computed tomography in infantile spasms].

A prospective investigation of 52 children with infantile spasms was carried out employing computed tomography. Normal conditions were demonstrated in 21 (40%). Among the 31 children with pathological computed tomografic findings, dilatation of the ventricular system and/or subarachnoid space was found in nine cases (17%), congenital malformations in ten (19%) and cerebrovascular changes in a similar number (19%). One patient had a tumour and one had congenital toxoplasmosis. No significant differences were found in the frequencies of normal psychomotor development between children with normal and abnormal computed tomographic findings. The reason for this is probably that a good prognosis may be anticipated in the idiopathic forms provided that ACTH treatment is initiated early in the course of the disease. Computed tomography is useful to differentiate between symptomatic and idiopathic cases of infantile spasms. It may, however, be assumed that neuronal heterotopy without other malformations in the central nervous system may be difficult to diagnose with computed tomography. Magnetic resonance scanning will probably be able to demonstrate these cases.