1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-8-02-b 10.15844/pedneurbriefs-8-1-3 Seizure Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant ACTH Efficacy in Symptomatic Infantile Spasms http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 01 1994 01 06 2016 8 1 2 3 Copyright: © 1994 The Author(s) 1994 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Therapeutic efficacy of ACTH in symptomatic infantile spasms with hypsarrhythmia

A retrospective evaluation of 26 case records of patients with diagnoses of symptomatic infantile spasms and classic hypsarrhythmia is reported from the Division of Pediatric Neurology, University of Minnesota Medical School, Minneapolis, MN.

 Symptomatic Infantile Spasms Hypsarrhythmia Toxicity

A retrospective evaluation of 26 case records of patients with diagnoses of symptomatic infantile spasms and classic hypsarrhythmia is reported from the Division of Pediatric Neurology, University of Minnesota Medical School, Minneapolis, MN. Seventeen (65%) had complete control of spasms and 9 did not respond. Both responders and nonresponders received similar ACTH dosages (87.4 and 84.5 U/m2, respectively). High-dose ACTH (>100 U/m2) was not more effective than lower dose regimens. Favorable outcome was associated with late onset (>8 months of age) and prompt treatment (1 month of onset). Responders either improved or did not deteriorate in development, whereas nonresponders were more impaired neurologically. [1]

COMMENT. The control of seizures in responders occurred in 1.6 weeks (0.5-6), and hypsarrhythmia disappeared in all. Despite the symptomatic nature of the infantile spasms and pre-treatment neurologic abnormalities, the results of moderate and relatively short duration ACTH dosage can be satisfactory provided seizure onset is delayed until after 4 months of age and treatment is initiated promptly. High dose regimens with increased risk of serious toxicity are apparently not justified. The need for early diagnosis and treatment has been emphasized previously. [2]

 Sher PK Sheikh MR Therapeutic efficacy of ACTH in symptomatic infantile spasms with hypsarrhythmia Pediatr Neurol 1993 Nov-Dec 9 6 451 456 10.1016/0887-8994(93)90024-7 7605553 Millichap JG JAMA 1962 182 125 10.1001/jama.1962.03050440015004