[Selected data from childhood epilepsies. ACTH treatment and ketogenic diet: a critical evaluation]

The authors have evaluated critically the results of ACTH and ketogenic diet in 122 cases of 'malignant' childhood epilepsies, especially West-syndrome (WS) and Lennox-Gastaut-syndrome (LGS). In agreement with data from the literature about 10% of the idiopathic forms recovered with or without ACTH. In the other cases ACTH caused a transient amelioration of the EEG and/or the spasms; a high-dosage regimen of ACTH was not significantly better than a low-dosage regimen. Fatal complications only occurred in the high-dosage ACTH group. Ketogenic diet in 10 children with LGS seems to have an influence on the LGS-specific seizures but not on the other signs and symptoms of the syndrome. The diet is difficult to maintain and is not free of side-effects.