title: ACTH therapy in infantile spasms: relationship between dose of ACTH and initial effect or long-term prognosis.
abstract: The relationship between the dose of ACTH and the initial effect was investigated in 41 children with infantile spasms. More than 0.015 mg (0.6 IU)/kg/day of ACTH was needed for a good initial response of seizures and electroencephalographic abnormalities. The relationship between the dose of ACTH and long-term prognosis was investigated in 29 patients. There was no relationship between the daily or total ACTH dosage, provided the dose was greater than 0.015 mg (0.6 IU)/kg/day, and the outcome of seizures and electroencephalographic abnormalities; however, ACTH 0.04-0.06 mg (1.6-2.4 IU)/kg/day and a total ACTH dose of 1.1-1.5 mg (44-60 IU)/kg resulted in better mental development than smaller doses of ACTH. Side effects of ACTH increased with dosage. Too small or too large a dose of ACTH does not lead to better mental development. The proper dose of ACTH should be used with careful attention to potential side effects.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Kyoto University, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ito
authors.forename: T
authors.initials: T
authors.lastname: Okuno
authors.forename: T
authors.initials: T
authors.lastname: Fujii
authors.forename: K
authors.initials: K
authors.lastname: Mutoh
authors.forename: K
authors.initials: K
authors.lastname: Oguro
authors.forename: H
authors.initials: H
authors.lastname: Shiraishi
authors.forename: Y
authors.initials: Y
authors.lastname: Shirasaka
authors.forename: H
authors.initials: H
authors.lastname: Mikawa
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000008:administration & dosage*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography / Q000187:drug effects; D005071:Evoked Potentials / Q000187:drug effects; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D013036:Spasms, Infantile / Q000188:drug therapy*
chemical_list: D000324:Adrenocorticotropic Hormone