Long-Term Outcome

The prognosis in West syndrome is poor overall, although a small number of individuals recover, with both resolution of seizures and achievement of normal mental development. While the natural history of this disorder is, in general, well documented, major questions remain unanswered regarding the factors that influence, or predict, outcome, and the long-term benefits of various therapeutic modalities. As discussed in the preceding chapter, a number of therapies have demonstrated efficacy for the control of spasms and improvement of the EEG characteristics. In this chapter, the evidence for an effect of such treatment on long-term outcome is considered, and we attempt to distinguish changes that are simply a part of the natural history of the disorder from those that are truly associated with therapeutic intervention.