Clinical and Therapeutic Strategies for West Syndrome in Low‐Resource Settings: A 10‐Year Experience From Cameroon

ABSTRACT Aim This retrospective cohort study reviewed medical records of 84 children diagnosed with infantile epileptic spasm syndrome (IESS) between 2015 and 2024 at the Douala Gyneco‐Obstetric and Pediatric Hospital. Patients were invited for follow‐up clinical assessment, with 67 children (79.8%) completing follow‐up evaluations under a child neurologist's supervision. Methods The study reviewed medical records and conducted follow‐up examinations. Data on socio‐demographic, clinical and therapeutic features were analysed using SPSS 30.0. Results The prevalence of IESS was 0.34%, with mean symptom onset at 6.73 ± 4.02 months. The most common presentation was epileptic spasms (77.4%), predominantly flexion type (73%). Median diagnostic delay was 2.0 months (IQR: 1–3 months), with 65.5% of families initially seeking traditional medicine. The primary etiologies were perinatal asphyxia (64.3%), cerebral malformations (11.9%) and prematurity‐associated brain injury (8.3%). Notably, 72.6% of infants had documented neonatal infections, which may have contributed to the pathophysiology in conjunction with other etiological factors. Electroencephalography revealed hypsarrhythmia in 97.6% of cases. Corticosteroids were the most frequent treatment (78.6%). Outcomes were poor, with high mortality (25.4%) and persistent developmental delays (90.0%). Interpretation The high mortality and developmental delays highlight the need for urgent interventions in low‐resource settings, including: early diagnostic algorithms, discouraging delays due to traditional medicine, improving neonatal infection control, ensuring corticosteroid availability and implementing paediatric neurology teleconsultation to improve outcomes.