Can ACTH therapy improve the long-term outcome of drug-resistant frontal lobe epilepsy?
Frontal lobe epilepsy is a common focal epilepsy in children and is often difficult to treat. Adrenocorticotropic hormone (ACTH) or steroids have been used for patients with several forms of medically intractable epilepsy. We evaluated the short, medium, and long-term evolution of patients with frontal lobe epilepsy and secondary bilateral synchrony on the EEG, who received ACTH treatment. Patients were recruited for an add-on trial during clinical practice, and data was retrospectively analysed. The study group comprised 6 patients treated with ACTH. The effects of ACTH were assessed in the short term (at the end of a 6-week period of ACTH treatment), medium term (at 6 months after the end of treatment), and long term (at 12 months after the end of treatment). At short-term follow-up, ACTH treatment was effective for all types of seizures in 5 of 6 patients and ineffective in 1 patient. All patients who were seizure-free at the end of ACTH treatment maintained an excellent outcome, remaining seizure-free at the end of follow-up. Our study demonstrates that ACTH may represent an effective treatment for frontal lobe epilepsy with secondary bilateral synchrony. Further double-blind prospective studies are required to confirm our initial findings.
Child Neurology Unit, IRCCS (Istituto delle Scienze Neurologiche di Bologna), Bellaria Hospital, Bologna.
Giuseppe
G
Gobbi
Department of Paediatrics, University of Chieti, Chieti.
Giulia
G
Loiacono
Child Neurology Unit, IRCCS (Istituto delle Scienze Neurologiche di Bologna), Bellaria Hospital, Bologna.
Antonella
A
Boni
Department of Paediatrics, Arcispedale S. Anna-University of Ferrara, Ferrara.
Lucia
L
Marangio
Department of Paediatrics, University of Perugia, Perugia, Italy.
Alberto
A
Verrotti
D000293:Adolescent; D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use*; D017668:Age of Onset; D001921:Brain / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004351:Drug Resistance; D004569:Electroencephalography; D017034:Epilepsy, Frontal Lobe / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy; D016896:Treatment Outcome
D000324:Adrenocorticotropic Hormone
ACTH; antiepileptic drug; epilepsy; frontal lobe epilepsy