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November 1989, Vol 143, No. 11 >
Article | November 1989

Low-Dose Alternate-Day Corticotropin Therapy in the Treatment of Childhood Seizures FREE

JOSEPH M. DOOLEY, MB, FRCPC; PETER R. CAMFIELD, MD, FRCPC; KEITH J. GOULDEN, MD, FRCPC; SHEILA R. MacKEN, MB, FRCPC
Am J Dis Child. 1989;143(11):1263-1265. doi:10.1001/archpedi.1989.02150230021013.
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Sir.—Corticotropin was used to treat 17 children with intractable epilepsy other than infantile spasms. Treatment was brief, averaging 5.9 weeks, with 3 to 6 1U/kg per day as the starting dose. Remission of seizures, persisting for a year or more, was achieved in 5 (55.6%) of 8 children with myoclonic/akinetic seizures but in none of the 9 patients with intractable generalized clonic or complex partial seizures (GTC-CPS) (P<.01, Fisher's Exact Test). No patient suffered serious side effects.

A short course of low-dose corticotropin therapy appears useful for some children with myoclonic/akinetic seizures but not for patients with intractable GTC-CPS epilepsy.

Corticotropin has been recognized as a valuable anticonvulsant since 1950.1 Its use, however, has been mainly confined to children with infantile spasms. In 1983, Snead et all reported that corticotropin completely controlled the seizures in all 52 patients studied with infantile spasms and in 74% of 64 children

REFERENCES

1 +
Klein R, Livingston S.  The effect of adrenocorticotrophic hormone in epilepsy . J Pediatr . 1950;;37:733-742.
2 +
Snead OC, Benton JW, Myers GI.  ACTH and prednisone in childhood seizure disorders . Neurology . 1983;;33:966-970.
3 +
Dreifuss F, Farwell J, Holmes G, et al.  Infantile spasms: comparative trial of nitrazepam and corticotropin . Arch Neurol . 1986;;43:1107-1110.
4 +
Abrams GM, Nilaver G, Hoffman D, et al.  Immunocytochemical distribution of corticotrophin (ACTH) in monkey brain . Neurology . 1980;;30:1106-1110.
5 +
Kendall DA, McEwan BS, Enna SJ.  The influence of ACTH and corticosterone on [3H]GABA receptor binding in rat brain . Brain Res . 1982;;236:365-374.
6 +
Holmes GL, Weber DA.  Effects of ACTH on seizure susceptibility in the developing brain . Ann Neurol . 1986;;20:82-88.
7 +
O'Donohoe NV. Epilepsies of Childhood . Stoneham, Mass: Butterworths; 1985;:31-36.
8 +
Snead OC, Hosey L, Swann J, et al.  High-dose ACTH in infantile spasms and mixed seizure disorders of children: efficacy and plasma ACTH and cortisol levels . Ann Neurol . 1986;;20:419.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

1 +
Klein R, Livingston S.  The effect of adrenocorticotrophic hormone in epilepsy . J Pediatr . 1950;;37:733-742.
2 +
Snead OC, Benton JW, Myers GI.  ACTH and prednisone in childhood seizure disorders . Neurology . 1983;;33:966-970.
3 +
Dreifuss F, Farwell J, Holmes G, et al.  Infantile spasms: comparative trial of nitrazepam and corticotropin . Arch Neurol . 1986;;43:1107-1110.
4 +
Abrams GM, Nilaver G, Hoffman D, et al.  Immunocytochemical distribution of corticotrophin (ACTH) in monkey brain . Neurology . 1980;;30:1106-1110.
5 +
Kendall DA, McEwan BS, Enna SJ.  The influence of ACTH and corticosterone on [3H]GABA receptor binding in rat brain . Brain Res . 1982;;236:365-374.
6 +
Holmes GL, Weber DA.  Effects of ACTH on seizure susceptibility in the developing brain . Ann Neurol . 1986;;20:82-88.
7 +
O'Donohoe NV. Epilepsies of Childhood . Stoneham, Mass: Butterworths; 1985;:31-36.
8 +
Snead OC, Hosey L, Swann J, et al.  High-dose ACTH in infantile spasms and mixed seizure disorders of children: efficacy and plasma ACTH and cortisol levels . Ann Neurol . 1986;;20:419.

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