West syndrome is an age-dependent epileptic encephalopathy that occurs in infants and toddlers. We present a case of a 7-month-old girl noted to have a specific facial appearance after birth and who was diagnosed with a 21-trisomy on chromosome testing. She had epileptic spasm at around 7 months of age and EEG test revealed hypsarrhythmia. The patient was diagnosed with West syndrome and was referred to our hospital for further investigation, where she was admitted and clonazepam （CZP） was prescribed. ACTH therapy commenced and the patient showed improvement based on EEG findings and decreased epileptic spasm. However, tonic seizures appeared with fast-wave rhythms on EEG. Believing that this seizure was not epileptic spasm, we suspected benzodiazepine-induced seizure（BIS） as previously reported and reduced the CZP.
The fast-wave rhythms disappeared and the seizures were decreased. If new seizures are observed during treatment of West syndrome, we need to differentiate the BIS.
ACTH 療法中に新たな発作を認め，benzodiazepine-induced seizure と考えられたWest 症候群の1例
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