Abstract | PURPOSE: METHODS: Patients with infantile spasms, who were treated with ACTH, were divided into three groups based on the aetiologies: unknown aetiology with normal development (unknown-normal), structural-acquired, and combined-congenital aetiologies that included genetic, metabolic, structural-congenital, or unknown aetiology with developmental delay. RESULTS: Of the 107 patients included (58 males, 49 females), 25 patients had unknown-normal aetiology [median age at onset 5 months, standard deviation (SD) 3.12, range 2-16 months]; 20 patients had structural-acquired aetiology (median age at onset 6.5 months, SD 3.85 months, range 4-17 months); and 62 patients had combined-congenital aetiologies (median age at onset 5 months, SD 2.73 months, range 2-16 months). The efficacy of ACTH was 64.0 %, 65 %, and 30.6 % in the unknown-normal aetiology, structural-acquired aetiology, and combined-congenital aetiologies, respectively (p < 0.01). Multivariate analysis showed a statistically significant higher efficacy in the unknown-normal aetiology [Odds ratio (OR) 4.63, 95 % confidence interval (CI) 1.60-13.30] and structural-acquired aetiology (OR 3.41, 95 % CI 1.01-11.50) compared to that in the combined-congenital aetiologies. CONCLUSION:
Infantile spasms with structural-acquired aetiology had greater response to ACTH treatment than those with combined-congenital aetiologies. The efficacy of standard therapy of infantile spasms should be considered based on aetiology.
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Authors | Atsuro Daida, Shin-Ichiro Hamano, Kuniyoshi Hayashi, Hazuki Nonoyama, Satoru Ikemoto, Yuko Hirata, Ryuki Matsuura, Reiko Koichihara, Gaku Yamanaka, Kenjiro Kikuchi |
Journal | Seizure
(Seizure)
Vol. 85
Pg. 6-11
(Feb 2021)
ISSN: 1532-2688 [Electronic] England |
PMID | 33360040
(Publication Type: Journal Article)
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Copyright | Copyright © 2020 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved. |
Chemical References |
- Anticonvulsants
- Adrenocorticotropic Hormone
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Topics |
- Adrenocorticotropic Hormone
(therapeutic use)
- Age of Onset
- Anticonvulsants
(therapeutic use)
- Female
- Humans
- Infant
- Male
- Spasms, Infantile
(drug therapy, etiology)
- Treatment Outcome
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