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Further observations on the treatment of infantile spasms with corticotropin
Insights
Corticotropin treatment for infantile spasms showed promising results. This therapy led to normalization in many patients, even allowing them to discontinue other anticonvulsants.
Area of Science:
- Pediatric Neurology
- Endocrinology
Background:
- Infantile spasms are a severe epilepsy syndrome in infants.
- Treatment options for infantile spasms can have significant side effects.
Purpose of the Study:
- To evaluate the efficacy and safety of corticotropin in treating infantile spasms.
- To assess outcomes in both idiopathic and secondary cases of infantile spasms.
Main Methods:
- Retrospective analysis of 33 patients with infantile spasms treated with corticotropin.
- Dosage regimen: 2 U/Kg/bw for 10 days, then 10 U/Kg/bw on alternate days for 20 days.
- Clinical and EEG assessments were used to determine normalization and improvement.
Main Results:
- In 8 idiopathic cases, 5 achieved full clinical and EEG normalization, remaining seizure-free without anticonvulsants.
- In 25 secondary cases, 1 achieved complete normalization, and 15 showed improvement.
- Treatment was associated with few side effects.
Conclusions:
- Low-dose, short-term corticotropin therapy is effective for infantile spasms.
- This treatment approach yields results comparable to literature standards with a favorable side effect profile.
- Corticotropin offers a viable therapeutic option for infantile spasms, potentially reducing the need for long-term anticonvulsant use.
Abstract:
The results of corticotropin treatment of 33 subjects with infantile spasms are reported. In 8 patients the disease was idiopathic and in 25 secondary. Among the idiopathic cases, full clinical and EEG normalization was obtained in 5. No anticonvulsants were given after the corticotropin treatment. All children have remained normal without therapy. Among the 25 secondary cases, complete normalization was obtained in one with meningioma and improvement in 15 others. The dosage of ACTH was usually 2 U/Kg/bw for 10 days and 10 U/Kg/bw on alternate days for a further 20 days. These findings indicate that therapeutic results quite similar to the most favourable reported in the literature can be obtained, with few side effects, with a low dosage and a short period of treatment with corticotropin.