Effect of adrenocorticotropic hormone on infantile spasms caused by different perinatal factors

Objective To analyze the effects of adrenocorticotropic hormone(ACTH)on infantile spasms(IS)children with neonatal brain injury caused by different types of perinatal factors. Methods Children with IS less than 1 year and the age of initial treatment with ACTH less than 2 years admitted to the first medical center of Chinese PLA General Hospital from September 2016 to September 2018 were included in our study.According to the etiology,patients were divided into IS with neonatal hypoglycemia encephalopathy group(n=38)and IS with neonatal hypoxic-ischemic encephalopathy(HIE)group(n=40).They were all given ACTH2.5 U/(kg·d)and MgSO₄0.25 g/(kg·d)for 2 weeks,and then the effects of ACTH were compared between the two groups.The seizures stopped or the EEG peak disappeared were defined as effective. Results ACTH was effective in 10 cases(26.3%)with IS caused by neonatal hypoglycemia encephalopathy,and in 24(60%)cases with IS caused by HIE,with statistically significant difference(P=0.03). Conclusion ACTH is less effective in infantile spasms caused by hypoglycemia than that caused by HIE.