Abstract:

Objective  To evaluate the therapeutic efficacy and adverse reaction of two different dosages of adrenocorticotropic hormone (ACTH)for infantile spasms by a retrospective study. Methods  A total of 78 children with infantile spasms were divided into two groups: the low dose group including 13 cryptogenic and 29 symptomatic cases were given ACTH 1IU／(kg·d), and the conventional dose group including 10 cryptogenic and 26 symptomatic cases were given ACTH 25～40IU／(kg.d). The two groups were both administered for four weeks. Then, the clinical efficacy, changes of EEG, and adverse reactions were compared with each other. At the same time, the factors that may affect therapeutic efficacy were analyzed with logistic regression. Results  (1) There was no statistical difference in response rate between the low dose and conventional dose groups(71.4％ vs 61.1％, P>0.05). (2) There was no statistical difference in remission rate of EEG between the low dose and conventional dose groups(69.0％ vs 63.9％,P>0.05). (3) Therapeutic efficacy was significantly related to the pathogenesis and course of the disease. There was a statistical difference in response rate between the cryptogenic and symptomatic children (86.3％ vs 57.1％, P<0.05); there was a statistical difference in response rate between the children whose disease duration was≤one month and those whose disease duration was> one month (79.4％ vs 54.5％, P<0.05). (4) There was a statistical difference in the adverse reaction between the conventional dose and low dose groups(14.3％ vs 38.9％, P<0.05). Conclusion  Low-dose ACTH has an obvious short-term therapeutic efficacy and less adverse reaction, so it can be recommended for the treatment of infantile spasms.

Key words: Spasms, infantile; Corticotropin; Epilepsy