Case report West syndrome following deep hypothermic infant cardiac surgery

Postoperative seizures are among the more common complications of cardiac surgery in children. These seizures have traditionally been considered benign, transient phenomena with little, if any, prognostic significance. We report 4 infants with early postoperative seizures following cardiac surgery who later developed the previously unreported complication of West syndrome, with infantile spasms, hypsarrhythmia, and developmental delay. This group constitutes 6% of 67 infant spasms evaluated over a 5-year period at Boston Childrens' Hospital. The postoperative seizures in these 4 patients were more difficult than usual to control with antiepileptic therapy; otherwise no intra- or perioperative features distinguished these infants who later developed West syndrome from infants with apparently benign "postpump seizures.".