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Journal of Child Neurology
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Hypothalamo-Pituitary-Adrenal Function in Infantile Spasms: Effects of ACTH Therapy

Jayashree K. Rao, MD

Department of Pediatrics, Louisiana State University School of Medicine

John Willis, MD

Department of Pediatrics, Louisiana State University School of Medicine, Department of Neurology Louisiana State University School of Medicine, New Orleans, LA

The metyrapone test was used to study the hypothalamo-pituitary-adrenal function in ten children with infantile spasms, before and after ACTH treatment. The hypothalamo-pituitary-adrenal response was normal before ACTH treatment in almost all children. After ACTH, the responses of two children were suggestive of a diminished pituitary reserve; three were suggestive of decreased adrenal as well as decreased pituitary reserve, and one suggested either adrenal hyperplasia with normal pituitary reserve, or appropriate response to a developing medical stress. We suggest that, in children being treated with ACTH, the dosage of ACTH should be gradually tapered, AM cortisol levels should be monitored, and high-dose steroids should be included when treating medical stress. (J Child Neurol 1987;2:220-223).

Journal of Child Neurology, Vol. 2, No. 3, 220-223 (1987)
DOI: 10.1177/088307388700200309
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