PMID: 8980843Nov 1, 1996Paper

West syndrome: individualized ACTH therapy

Brain & Development
H HeiskalaJ Perheentupa

Abstract

Individualized ACTH treatment of the West syndrome (WS) was assessed in a prospective multicenter study, in which each patient's dosage was increased stepwise according to response. Our series included six patients with cryptogenic and 24 with symptomatic infantile spasms. During the treatment period the total ACTH dose ranged from 58 to 373 i.u./kg. In the cryptogenic group one patient responded to pre-ACTH pyridoxine and four to the lowest dosage of ACTH (3 i.u./kg daily) with cessation of spasms and good outcome; one patient needed the highest dosage (12 i.u./kg daily) for cessation of seizures and became developmentally retarded. In the symptomatic group, 21 of the 24 patients needed 6-12 i.u./kg daily; 12 became seizure-free or having infrequent non-IS fits. Complications such as arterial hypertension, cerebral ventricle dilatation, cardiac hypertrophy, and prolonged adrenocortical hyporesponsiveness were related to the dose. The individualization provides all the benefits of ACTH treatment with minimal side effects and cost.

References

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Citations

Nov 1, 1996·Brain & Development·O C Snead
Nov 1, 1996·Brain & Development·A FoisS Foderi
Oct 16, 1999·Brain & Development·S YanagakiM Osawa
Dec 19, 2000·Pediatric Neurology·R S Riikonen
Jan 30, 2002·Pediatric Neurology·Michael J Kubek, Bhuwan P Garg
Dec 9, 1997·Pediatric Neurology·R S RiikonenD B Lindholm
Apr 14, 1999·Psychiatry and Clinical Neurosciences·M KimuraS Yamaguchi
May 1, 2002·Clinical Neuropharmacology·Mohamad A MikatiGregory L Holmes
Nov 10, 2001·Brain & Development·R Riikonen
Nov 10, 2001·Brain & Development·R E Appleton
Jun 18, 1999·Brain & Development·S YanaiO Narazaki
Apr 14, 2009·European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society·Raili S Riikonen
Jul 2, 2011·Journal of Child Neurology·Carl E StafstromJohn W Swann
Sep 15, 2009·Journal of Child Neurology·Arthur Partikian, Wendy G Mitchell
Mar 26, 2005·Current Opinion in Neurology·Raili Riikonen
Mar 1, 2012·Expert Review of Neurotherapeutics·Eija Gaily
Sep 28, 2004·Journal of Child Neurology·Jaana TyyneläSara E Mole
Sep 28, 2004·Journal of Child Neurology·Raili Riikonen

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