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ACTH therapy for infantile spasms: a combination therapy with high-dose pyridoxal phosphate and low-dose ACTH.

Abstract
Combination therapy consisting of high-dose pyridoxal phosphate (40-50 mg/kg/day) and low-dose synthetic ACTH (0.01 mg/kg/day) was prescribed in 28 children with infantile spasms. Monotherapy with pyridoxal phosphate provided excellent seizure control in 3 of the 28 (11%) patients. ACTH was subsequently added to the regimen of the remaining 25 patients. As of 1 month after discontinuing the ACTH treatment, 21 of the 25 (84%) patients had experienced no seizures. The mean interval until seizure control was achieved was 4.1 days after the start of treatment with ACTH. The 21 patients have been monitored for a mean of 34.9 months (range 2-81 months); 6 patients (29%) have had recurrences of infantile spasms, and 10 (48%) have experienced normal development. Fourteen of the 28 patients (50%) have had transient increases in liver enzymes, but none of the patients developed more serious side effects.
AuthorsY Takuma
JournalEpilepsia (Epilepsia) Vol. 39 Suppl 5 Pg. 42-5 ( 1998) ISSN: 0013-9580 [Print] United States
PMID9737444 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Anticonvulsants
  • Cosyntropin
  • Pyridoxal Phosphate
  • Pyridoxine
Topics
  • Age of Onset
  • Anticonvulsants (administration & dosage, therapeutic use)
  • Child, Preschool
  • Cosyntropin (administration & dosage, therapeutic use)
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Pyridoxal Phosphate (administration & dosage, therapeutic use)
  • Pyridoxine (therapeutic use)
  • Recurrence
  • Spasms, Infantile (drug therapy)
  • Treatment Outcome

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