ACTH therapy for infantile spasms: a combination therapy with high-dose pyridoxal phosphate and low-dose ACTH

Epilepsia. 1998;39 Suppl 5:42-5. doi: 10.1111/j.1528-1157.1998.tb05149.x.

Abstract

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.

Publication types

  • Clinical Trial

MeSH terms

  • Age of Onset
  • Anticonvulsants / administration & dosage
  • Anticonvulsants / therapeutic use*
  • Child, Preschool
  • Cosyntropin / administration & dosage
  • Cosyntropin / therapeutic use*
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Pyridoxal Phosphate / administration & dosage
  • Pyridoxal Phosphate / therapeutic use*
  • Pyridoxine / therapeutic use
  • Recurrence
  • Spasms, Infantile / drug therapy*
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Cosyntropin
  • Pyridoxal Phosphate
  • Pyridoxine