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Early Intervention With Adrenocorticotropin for Acute Encephalopathy-Associated Epileptic Spasms: Report of Two Cases

Kousuke Yonemoto1, Yuko Ichimiya1,2, Masafumi Sanefuji1

  • 11 Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Clinical EEG and Neuroscience
|July 10, 2018
PubMed

Insights

Adrenocorticotropic hormone (ACTH) effectively treated epileptic spasms in two children with acute encephalopathy with biphasic seizures and reduced diffusion (AESD). This treatment provided over a year of seizure relief, offering a new therapeutic option.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Neurocritical Care

Background:

  • Acute encephalopathy with biphasic seizures and reduced diffusion (AESD) is a significant cause of childhood encephalopathy in Japan.
  • Children with AESD often develop difficult-to-treat epilepsy, necessitating novel therapeutic strategies.

Observation:

  • Two unrelated girls diagnosed with AESD at 12 and 25 months of age experienced severe neurological impairments despite intensive care.
  • Both patients developed recurrent epileptic spasms months after the initial AESD onset, confirmed by EEG as characteristic epileptic spasms.

Findings:

  • Intramuscular adrenocorticotropic hormone (ACTH) treatment was initiated within one month of epileptic spasm onset.
  • ACTH administration for two weeks successfully suppressed paroxysmal EEG activity and eliminated seizures for over a year in both cases.

Implications:

  • This case study suggests adrenocorticotropic hormone (ACTH) may be a promising treatment for children experiencing epileptic spasms secondary to AESD.
  • Further research is warranted to confirm the efficacy and safety of ACTH in a larger cohort of AESD patients with epilepsy.
Abstract

Keywords:
acute encephalopathy with biphasic seizures and reduced diffusion (AESD)and adrenocorticotropic hormone (ACTH)electroencephalogram (EEG)epileptic spasms

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