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标题:Adrenocorticotropic Hormone versus Pulsatile Dexamethasone in the Treatment of Infantile Epilepsy Syndromes
时间:2019-12-03 23:09:42
DOI:10.1016/j.pediatrneurol.2009.07.011
作者:Edda Haberlandt;Christine Weger;Sara Baumgartner Sigl
关键词:Brain;Humans;Epilepsy;Spasms, Infantile;Seizures;Status Epilepticus;Syndrome;Dexamethasone;Anticonvulsants;Electroencephalography
摘要:For treatment of intractable epilepsies, there are no data comparing conventional adrenocorticotropic hormone and pulsatile corticoid therapy with dexamethasone. A retrospective comparison of efficacy was therefore conducted for both forms of application. Between 1989 and 2001, a series of 11 children with West syndrome and 3 with Lennox-Gastaut syndrome were treated with adrenocorticotropic hormone (group 1); between 2003 and 2006, 7 children with West syndrome, 5 with electrical status epilepticus during slow sleep, and 2 with Lennox-Gastaut syndrome were treated with pulsatile corticoid therapy (group 2). In group 1 ( n = 14), 9/11 West syndrome patients became seizure free, but none with Lennox-Gastaut syndrome (0/3). In group 2 ( n = 14), 4/7 West syndrome patients became seizure-free, 1/2 with Lennox-Gastaut syndrome exhibited seizure-frequency reduction, and 2/5 patients with electrical status epilepticus during slow-wave sleep exhibited significant improvement according to electroencephalograms. In West syndrome, pulsatile corticoid therapy was an effective alternative treatment to adrenocorticotropic hormone, whereas in Lennox-Gastaut syndrome in general steroids did not lead to a significant seizure reduction. In electrical status epilepticus during slow-wave sleep, treatment with pulsatile corticoid therapy seems to be effective and should be investigated in a larger group of patients.
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目录:
  • Adrenocorticotropic Hormone versus Pulsatile Dexamethasone in the Treatment of Infantile Epilepsy Syndromes
    • Introduction
    • Methods
    • Results
      • Changes in EEG
      • Changes in Seizure Frequency
      • Changes in Seizure Frequency in the Individual Syndromes
      • Time Interval to Change in EEG
      • Time Interval to Change in Seizure Frequency
      • Adverse-Effects Profile
    • Discussion
    • References

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