All issues > Volume 35(4); 1992

Original Article

J Korean Pediatr Soc. 1992;35(4):459-469. Published online April 15, 1992.

A Clinical Study on Infantile Spasms with ACTH Therapy

Se Hee SH Hwang¹, Yong Seung YS Hwang¹

¹Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea

Abstract

Infantile spasms is a disease, causes or treatments of which are not clearly delineated. Pri-mary objectives of treatment are complete control of seizure attack and prevention of further brain damage. Forty-one patients were managed with ACTH, who were diagnosed as infantile spasms and admitted to the Department of Pediatrics, Seoul National University Hospital from July 1985 till June 1990. The results were as follows: 1) The ratio of male to female was 1.05 : 1 2) Range at the age of onset was from only three days to eighteen months. Twenty-six cas-es(68.3%) were between three months and nine months. Mean age of patients is 9 month old and mean duration from onset of the disease to the beginning of the treatment is 3.1 months. 3) The most common type of infantile spasms is flexor type which is twenty-eight cases(63. 4%). 4) The associated diseases of infantile spasms are found in 75.6% of patients in this study. Symptomatic group might be increased with further refinement of diagnostic work-up. 5) Of thirty cases with developmental delay, fifteen were controlled and ten of the eleven c-ases without developmental delay were controlled. The difference between two groups is statis-tically significant (p<0.01). EEG findings were improved in thirty three patients(80.5%). Of them, twenty-one were clini-cally improved. However, two cases whose EEG findings were not improved were refractory to ACTH therapy. 7) The clincial responses to ACTH therapy were observed during the first week of initial high dose adminiatration on most(76%) of the ACTH responsive patients(25 patients).

Keywords :Infantile spasms, ACTH