case_images: PMC6951394_01
case_images: (A) Interictal awake electroencephalography at 7 months showing the characteristic random high-voltage slow waves with spikes and polyspikes activity. (B) Fragmentation of the hypsarrhythmic activity is noticed during sleep recording. (C) Ictal EEG recording showing a cluster of epileptic spasms with high amplitude slow wave at each spasm. (D) Sleep recording showed normalization of background EEG observed 2 months after treatment. (E) Axial T1-weighted image. (F) Axial T2-weighted image of cranial MRI before initiation of adrenocorticotropic hormone therapy at 7 months of age showing cerebral atrophy with frontal predominance and delay in myelination. Follow-up imaging after vitamin B12 supplementation at 14 months of age documenting improved delayed myelination and cerebral atrophy. (G) Axial T1-weighted image. (H) Axial T2-weighted image.
case_images: fped-07-00531-g0001.jpg
case_images: PMC6951394_01_fped-07-00531-g0001.jpg
case_images: F1
case_images: Interictal electroencephalograhy revealed typical hypsarrhythmia patterns during sleep and awake (Figures 1A,B). Ictal EEG demonstrated the typical findings of epileptic spasms (Figure 1C). Head circumference was 43.7 cm (-0.2 SDS), and cranial magnetic resonance imaging (MRI) revealed cerebral atrophy and delayed myelination (Figures 1E,F). Follow-up EEG at 2 months showed normalization of background EEG (Figure 1D).