ACTH Therapy for Two Cases of Epileptic Spasms without Hypsarrhythmia

DOI 7 References
  • Ishii Masahiro
    Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health
  • Shimono Masayuki
    Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health
  • Senju Ayako
    Department of Health Care & Support Center, Environment & Safety, UBE Industries, LTD.
  • Fukuda Tomofumi
    Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health
  • Shiota Naoki
    Department of Health Care & Support Center, Environment & Safety, UBE Industries, LTD.
  • Kusuhara Koichi
    Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health

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Other Title
  • ACTH療法が有効であったepileptic spasms without hypsarrhythmiaの2例

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Description

We present two patients with epileptic spasms without hypsarrhythmia (ESWoH) who were successfully treated with ACTH. One patient was an 18-month-old boy who had normal development for the first 16 months of his life. Thereafter, he experienced sudden flexion of the axial muscles, resulting in head nodings, or epileptic spasms (ES). EEG tracings showed generalized polyspikes that appeared frequently during sleep without associated hypsarrhythmia. We were thus able to diagnose him with ESWoH and treated him with ACTH, which resolved his seizures. Another patient was a 7-year-old boy. At 18 months of age, the patient began to sufferdil from sudden ES. Anti-epileptic drugs were administered individually and in combination but were proved ineffective. Like the first case, this child's EEG tracing showed generalized polyspikes during sleep without associated hypsarrhythmia. We diagnosed him with ESWoH and treated him with ACTH. His ES disappeared soon after the initiation of treatment. These two cases demonstrate the difficulty of treating ESWoH only with standard anti-epileptic drugs, we emphasize the importance of early treatment with ACTH.

Journal

  • NO TO HATTATSU

    NO TO HATTATSU 45 (1), 58-61, 2013

    The Japanese Society of Child Neurology

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