ACTH therapy for infantile spasms: a combination therapy with high-dose pyridoxal phosphate and low-dose ACTH.
Combination therapy consisting of high-dose pyridoxal phosphate (40-50 mg/kg/day) and low-dose synthetic ACTH (0.01 mg/kg/day) was prescribed in 28 children with infantile spasms. Monotherapy with pyridoxal phosphate provided excellent seizure control in 3 of the 28 (11%) patients. ACTH was subsequently added to the regimen of the remaining 25 patients. As of 1 month after discontinuing the ACTH treatment, 21 of the 25 (84%) patients had experienced no seizures. The mean interval until seizure control was achieved was 4.1 days after the start of treatment with ACTH. The 21 patients have been monitored for a mean of 34.9 months (range 2-81 months); 6 patients (29%) have had recurrences of infantile spasms, and 10 (48%) have experienced normal development. Fourteen of the 28 patients (50%) have had transient increases in liver enzymes, but none of the patients developed more serious side effects.
Takuma
Y
Y
Division of Neurology, Tokyo Metropolitan Kiyose Children's Hospital, Japan.
D017668:Age of Onset; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D002675:Child, Preschool; D003366:Cosyntropin / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011732:Pyridoxal Phosphate / Q000008:administration & dosage / Q000627:therapeutic use*; D011736:Pyridoxine / Q000627:therapeutic use; D012008:Recurrence; D013036:Spasms, Infantile / Q000188:drug therapy*; D016896:Treatment Outcome
D000927:Anticonvulsants; D003366:Cosyntropin; D011732:Pyridoxal Phosphate; D011736:Pyridoxine