Thyrotropin-releasing hormone in treatment of intractable epilepsy: neurochemical analysis of CSF monoamine metabolites.
The efficacy of thyrotropin-releasing hormone in children with intractable epilepsy was investigated and changes in cerebrospinal fluid monoamine metabolites were analyzed. The 18 patients had either West syndrome (12 patients) or Lennox-Gastaut syndrome (6 patients), which was intractable to antiepileptic drug therapy and to adrenocorticotrophic hormone. Thyrotropin-releasing hormone-tartrate was administered for 4 weeks. Before and after the thyrotropin-releasing hormone administration, cerebrospinal fluid was collected and analyzed for 5-hydroxyindoleacetic acid, kynurenine, homovanillic acid, and 3-methoxy-4-hydroxyphenyl glycol. The patients were classified into 3 groups, based on seizure frequency and electroencephalographic effects: cessation of seizures and seizure discharges (very effective; group A), reduction of seizures and/or seizure discharges (effective; group B), and no changes in frequency of seizures or discharges (not effective; group C). There were 6 patients in group A, 3 in group B, and 9 in group C. There were no significant differences in monoamine metabolites before and after the thyrotropin-releasing hormone therapy. A trial of thyrotropin-releasing hormone for the treatment of intractable epilepsy is warranted and further study is required on the mechanism of the antiepileptic action of thyrotropin-releasing hormone.
Takeuchi
Y
Y
Department of Pediatrics, Kyoto Prefectural University of Medicine, Japan.
Tominaga
M
M
Mitsufuji
N
N
Yamazoe
I
I
Kawase
S
S
Nishimura
A
A
Matsuo
S
S
Sawada
T
T
D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000187:drug effects; D004827:Epilepsy / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D005260:Female; D006719:Homovanillic Acid / Q000134:cerebrospinal fluid; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000134:cerebrospinal fluid; D007223:Infant; D007737:Kynurenine / Q000134:cerebrospinal fluid; D008297:Male; D008734:Methoxyhydroxyphenylglycol / Q000134:cerebrospinal fluid; D018377:Neurotransmitter Agents / Q000134:cerebrospinal fluid*; D013036:Spasms, Infantile / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D013973:Thyrotropin-Releasing Hormone / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D018377:Neurotransmitter Agents; D007737:Kynurenine; D008734:Methoxyhydroxyphenylglycol; D006897:Hydroxyindoleacetic Acid; D013973:Thyrotropin-Releasing Hormone; D006719:Homovanillic Acid