Effect of ACTH-induced hypercortisolemia on the EEG in patients with stress-related epilepsy.
OBJECTIVE
We assess the effect of acute hypercortisolemia induced by ACTH stimulation on seizures and EEG interictal spike activity in patients with localization-related epilepsy (LRE) and stress-related seizures.


METHODS
Seven patients (3 males, 4 females) with LRE and stress-related seizures were studied. All patients underwent ACTH stimulation with 0.25-0.75 mg Cosyntropin intravenously at 8 am. Serum cortisol and ACTH levels were monitored half- to one-hourly for 4 to 6 hours. Video/EEG monitoring was also performed.


RESULTS
ACTH injection induced hypercortisolemia in all patients. Hypercortisolemia was not associated with seizures or interictal spike facilitation in any patient. Two patients experienced seizures on the day of ACTH injection, one 8 hours after and another 15 and 12 hours after the injection, during a period when their cortisol levels had returned to normal.


CONCLUSIONS
No reproducible interictal EEG changes occurred in any of the patients following ACTH injection.
Klein
Pavel
P
Georgetown University Hospital, Washington, DC, USA. kleinp@epilepsydc.com
Sahoo
Sanjiv
S
D000293:Adolescent; D000304:Adrenal Cortex Function Tests; D000308:Adrenocortical Hyperfunction / Q000139:chemically induced / Q000503:physiopathology*; D000328:Adult; D003366:Cosyntropin / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography; D004827:Epilepsy / Q000145:classification / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000503:physiopathology; D013312:Stress, Physiological / Q000150:complications*; D013997:Time Factors
D003366:Cosyntropin; D006854:Hydrocortisone