ACTH therapy for generalized seizures other than spasms.
OBJECTIVE
We reviewed our experience with ACTH for the treatment of intractable generalized seizures other than spasms.


METHODS
Efficacy and adverse effects of ACTH against intractable generalized seizures other than spasms were retrospectively investigated in 15 patients treated between 1991 and 2003. The median age of the patients at ACTH therapy was 42 months. The targeted type of seizure was brief tonic in 6, atypical absence in 6, atonic in 2, and myoclonic in 1. The dose of ACTH was 0.01-0.015 mg/kg in most patients. The effect of ACTH was determined at the end of ACTH therapy, and 3 months and 1 year after ACTH therapy.


RESULTS
Seizure freedom was obtained in 13 of 15 patients. However, 6 of them had a recurrence of seizures within 3 months after ACTH therapy. ACTH was the most effective in patients with atypical absence seizures. Statistical analysis showed that the number of injection and total dose of ACTH were smaller in patients with atypical absence seizures than in those with brief tonic seizures. Adverse effects were frequent but serious one was not observed.


CONCLUSIONS
ACTH therapy was effective in patients with intractable generalized seizures other than spasms. However, its efficacy was often transient. ACTH can be useful for generalized seizures other than spasms but its limitation should be considered.
Okumura
Akihisa
A
Department of Pediatrics, Juntendo University School of Medicine, Tokyo 113-8421, Japan. okumura@med.juntendo.ac.jp
Tsuji
Takeshi
T
Kato
Toru
T
Natsume
Jun
J
Negoro
Tamiko
T
Watanabe
Kazuyoshi
K
D000324:Adrenocorticotropic Hormone / Q000009:adverse effects / Q000627:therapeutic use*; D000369:Aged, 80 and over; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography / Q000187:drug effects*; D004829:Epilepsy, Generalized / Q000188:drug therapy*; D005260:Female; D006728:Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D008297:Male; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies
D006728:Hormones; D000324:Adrenocorticotropic Hormone