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Infantile spasms belong to epileptic encephalopathies of early infancy and represent oneof the major causes for acquired mental retardation in early childhood. Cognitive andbehaviour impairments can be present even after benign course of disease. Cognitivedeficits are in correlation with treatment lag longer then one month, the risk of mentalretardation increases after three weeks of hypsarrhythmia duration. Recent studiesdemonstrate a negative influence of epileptic activity on cortical development in criticalperiod of early brain development. Early treatment is associated with favourableprognosis in cryptogenic as in some symptomatic infantile spasms; however, to preventspecific cognitive deficits early therapeutic strategies should be considered.