Seven‐Year Longitudinal Respiratory Morbidity in Ohtahara Syndrome: A Case Report Emphasizing Integrated Airway and Seizure Care in a Resource‐Limited Setting
Abstract
Introduction Ohtahara syndrome (OS) features neonatal‐onset tonic spasms with suppression–burst EEG, high early mortality, and evolution to other epileptic encephalopathies. Respiratory complications are frequent yet underdescribed longitudinally. Case We followed a female with neonatal‐onset OS and suppression–burst EEG to the age of seven. Despite combination antiseizure therapy (phenobarbital, levetiracetam, vigabatrin, and clonazepam), she had breakthrough events and severe developmental impairment. Between the ages 1 and 7 years, she experienced ≥ 15 documented hospitalizations for recurrent bronchopneumonia, frequently with hypoxemia requiring supplemental oxygen; several episodes were accompanied by seizure exacerbations and clinical aspiration or choking events. Management and Outcomes Admissions were managed with supportive respiratory care (oxygen, bronchodilators, and corticosteroids when indicated) and broad‐spectrum antimicrobials alongside ongoing seizure management, enabling survival to school age in a resource‐limited context. Conclusions In OS, respiratory complications, often driven by aspiration risk and impaired airway clearance, can become a dominant source of morbidity and should be addressed with the same priority as antiseizure therapy. We highlight practical pillars for long‐term care: proactive infection prevention and early treatment pathways; aspiration‐risk assessment with feeding/swallow support when feasible; airway‐clearance planning with…
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