Neurology: infantile spasms: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Neurology: infantile spasms

Sample item

A 6-month-old has clusters of flexor spasms with developmental regression, and EEG shows chaotic high-voltage activity with multifocal spikes. What is the EEG pattern and a first-line drug?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Hypsarrhythmia; ACTH or oral prednisolone or vigabatrin

West syndrome comprises infantile spasms, hypsarrhythmia and developmental arrest. ACTH, prednisolone and vigabatrin are first-line, with vigabatrin favoured in tuberous sclerosis. Early treatment improves developmental outcome.

Option by option

  • A. 3 Hz spike and wave; ethosuximide

    Three-hertz spike and wave is the pattern of absence epilepsy.

  • B. Normal EEG; no therapy

    The EEG is characteristically abnormal.

  • C. Hypsarrhythmia; ACTH or oral prednisolone or vigabatrin (correct)

    Correct. Hypsarrhythmia with hormonal therapy or vigabatrin.

  • D. Burst suppression; phenytoin

    Phenytoin is not effective for spasms.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Hypsarrhythmia; ACTH or oral prednisolone or vigabatrin. West syndrome comprises infantile spasms, hypsarrhythmia and developmental arrest.

Why is "3 Hz spike and wave; ethosuximide" not the answer?

Three-hertz spike and wave is the pattern of absence epilepsy.

Why is "Normal EEG; no therapy" not the answer?

The EEG is characteristically abnormal.

Why is "Burst suppression; phenytoin" not the answer?

Phenytoin is not effective for spasms.

What concept does this question test?

It tests Neurology: infantile spasms in Pediatrics. ACTH, prednisolone and vigabatrin are first-line, with vigabatrin favoured in tuberous sclerosis. Early treatment improves developmental outcome.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neurology: infantile spasms?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.