Question of the Week

Question :

Posted On : 18 Jan 2008

What is the role of using ACTH in treatment of infantile spasm?

Expert Answer :

No expert answer available.

Answer Discussion :

sahana sunil

supresses CRH whose receptors are overexpressed within thebrain of the infant

17 years ago

pediatriconcall

For approximately fifty years hormonal therapy with ACTH or prednisone has been the staple of treatment for infantile spasms. However, studies detailing the therapeutic properties of these compounds have been fraught with uncertainty. Many controversies still exist concerning the relative efficacy, optimal dose and timing, and predictive factors for good responsiveness to ACTH and corticosteroids. No placebo-controlled trials of ACTH or steroids have been performed. In most open-label or retrospective studies, ACTH or prednisone induces a reduction or complete cessation of spasms, as well as an improvement in the EEG, in approximately 50-75 Percent of patients. This effect is usually realized within a couple weeks. While some studies report similar efficacy of ACTH and prednisone, others indicate that ACTH is more effective. Some patients who do not initially respond to ACTH may respond to prednisone and vice-versa. A large variety of doses of ACTH have been used, but there is no evidence that larger doses {150 units - meter2-day} are more effective than lower doses {20-30 units-day}.

17 years ago

Mani Kant Kumar

Currently ACTH is the drug of choice for treatment of infantile spasm. At our institute {PGI Chandigarh} ACTH is treatment of choice for infantile spasm, and it effectively control seizure in

17 years ago

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