Analysis of the electroencephalographic features in infantile epileptic spasms syndrome of structural and unknown etiology based on graph theory.

Infantile Epileptic Spasm Syndrome (IESS) follows established treatment protocols, yet prognostic factors remain unclear. This study analyzed brain network characteristics in children with IESS. Sixteen children with IESS were enrolled, including 11 with structural etiology (S group) and 5 with unknown etiology (U group), all receiving hormone therapy. Eleven age-matched healthy children served as controls (C group). Two-second frequency bands were extracted from at least 20 min of video electroencephalogram (VEEG) recordings. The IESS group completed paired pre- and post-treatment VEEG recordings. Graph-theoretical analysis was applied to compute characteristic path length (CPL), nodal degree (ND), clustering coefficient (CC), and betweenness centrality (BC) based on mutual information across channels. Compared with the C group, both S and U groups showed decreased beta-band CPL and increased ND and CC during wakefulness. The S group had significantly lower ND and CC in the beta band across all interictal states compared with the U group. After treatment, the S group exhibited further reductions in beta-band CPL and increases in ND and CC during the waking ictal period. Children with IESS of structural and unknown etiologies show distinct brain network characteristics. Subtype-specific beta-band network variations provide a basis for investigating prognostic electrophysiological indicators in IESS, and their predictive performance needs validation via long-term cohort observation.