Infantile spasms: Brief and intermittent treatment with synthetic ACTH

Infantile spasms.

“…There is much anecdotal evidence but little scientific basis for the use of ACTH or corticosteroids; a recent report has valiantly attempted to explain and rationalise the multiple aetiologies, efficacy of hormonal treatment, and even spontaneous resolution of infantile spasms.40 In addition there is considerable variation in the preparation, dose, and duration of treatment and relapses are common, whether on or off treatment. 26 [41][42][43][44][45] More importantly these drugs are associated with frequent, severe, and potentially fatal side effects. Drug related mortality may be as high as 5%.46 ACTH and corticosteroids have also not been shown conclusively to improve the long term outcome of either the development of chronic epilepsy (which occurs in over 65% of children) or mental retardation.…”