Infantile Spasms in an Infant With Cytomegalovirus Infection Treated With Ganciclovir

A 3-month-old male infant with cytomegalovirus infection and intractable partial seizures was treated with ganciclovir for 6 weeks. The drug was well tolerated, and virus shedding in the cerebrospinal fluid and urine was eliminated, although infantile spasms at the age of 6 months appeared. At the age of 12 months, intractable seizures persisted, and the psychomotor development of the infant was markedly delayed. To our knowledge, no previous similar case has been reported. These findings suggest that treatment with ganciclovir of infants with cytomegalovirus infection results only in cessation of virus shedding in the cerebrospinal fluid and urine without having a preventive effect on the future appearance of infantile spasms. This may be due to the irreversibility of previous brain damage from the cytomegalovirus infection and the virostatic nature of the drug. (J Child Neurol 2004;19:50—53).

[1]  B. Crowley Ganciclovir treatment of symptomatic congenital cytomegalovirus infection. , 2002, The Journal of antimicrobial chemotherapy.

[2]  W. Shields West's Syndrome , 2002, Journal of child neurology.

[3]  J. Kohyama,et al.  Human cytomegalovirus DNA in cerebrospinal fluid. , 1994, Archives of disease in childhood.

[4]  G. Demmler,et al.  Polymerase chain reaction to detect cytomegalovirus DNA in the cerebrospinal fluid of neonates with congenital infection. , 1994, The Journal of infectious diseases.

[5]  H. Scholz,et al.  Ganciclovir therapy for symptomatic congenital cytomegalovirus infection in infants: a two-regimen experience. , 1994, The Journal of pediatrics.

[6]  R. Appleton Infantile spasms. , 1993, Archives of Disease in Childhood.

[7]  R. Riikonen,et al.  Infantile Spasms: Infectious Disorders , 1993, Neuropediatrics.

[8]  S. Attard-Montalto,et al.  Ganciclovir treatment of congenital cytomegalovirus infection: a report of two cases. , 1993, Scandinavian journal of infectious diseases.

[9]  T. Bergström,et al.  Cytomegalovirus encephalitis in four immunocompetent patients , 1992, The Lancet.

[10]  T. Markestad,et al.  Ganciclovir therapy of congenital cytomegalovirus disease , 1992, Acta paediatrica.

[11]  L. Cowan,et al.  The Epidemiology and Natural History of Infantile Spasms , 1991, Journal of child neurology.

[12]  R. Riikonen Cytomegalovirus Infection and Infantile Spasms , 1978, Developmental medicine and child neurology.

[13]  M. Midulla,et al.  INFANTILE SPASMS AND CYTOMEGALOVIRUS INFECTION , 1976, The Lancet.

[14]  K. Hara,et al.  The Evolution of EEG Features in Infantile Spasms: a Prospective Study , 1973, Developmental medicine and child neurology.