RT Book, Section A1 Go, Cristina Yip A1 Snead, III, O. Carter A2 Duchowny, Michael A2 Cross, J. Helen A2 Arzimanoglou, Alexis SR Print(0) ID 1138410857 T1 Infantile Spasms and West Syndrome T2 Pediatric Epilepsy YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071496216 LK neurology.mhmedical.com/content.aspx?aid=1138410857 RD 2024/03/29 AB In 1841, Dr. William J. West penned a letter to Lancet in which he described an unusual condition in his 4-month-old son, James, that was characterized by "… slight bobbings of the head forward"…which "… increased in frequency, and at length became so powerful, as to cause a compete heaving of the head forward toward his knees, and then immediately relaxing in an upright position. … these bowings and relaxings would be repeated alternately at intervals of a few seconds, and repeated from ten to twenty or more times at each attack, which attack would not continue more than two or three minutes; he sometimes has two, three, or more attacks in the day …." Dr. West went on to describe a reduction in a developmental trajectory in his child that was normal prior to the onset of these events: he states that since the onset of the spells his son "… neither possesses the intellectual vivacity, or the power of moving his limbs, of a child of his age." This remarkable letter, now over 160 years old, remains the most eloquent clinical description of what we now know as infantile spasms. It describes the relentless nature of the condition, the early age of onset, the classical clinical presentation, and the developmental regression associated with infantile spasms.1