Computed tomography in infantile spasms: effects of hormonal therapy.
During a prospective double-blind, crossover study of ACTH versus prednisone therapy, serial computed tomography (CT) scans were performed on 16 children with infantile spasms. Pre-treatment scans revealed four findings: normal (6 patients), generalized atrophy (bilaterally enlarged ventricles and/or subarachnoid space) (2 patients), predominantly focal atrophy (3 patients), and congenital anomalies (5 patients). Within 2 weeks of initiating relatively low therapeutic dosages of ACTH or prednisone, a significant number of the infants (63%) had CT findings consistent with decreased cortical volume; in many cases (44%), these findings had not reversed 4 to 6 weeks after discontinuing therapy. Duration of therapy did not correlate significantly with the persistence of CT changes.
Glaze
D G
DG
Department of Neurology, Baylor College of Medicine, Houston, TX 77030.
Hrachovy
R A
RA
Frost
J D
JD
Zion
T E
TE
Bryan
R N
RN
D000324:Adrenocorticotropic Hormone / Q000009:adverse effects* / Q000627:therapeutic use; D001284:Atrophy; D001921:Brain / Q000187:drug effects*; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D006801:Humans; D007223:Infant; D011241:Prednisone / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D013036:Spasms, Infantile / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed
D000324:Adrenocorticotropic Hormone; D011241:Prednisone