Elsevier

Pediatric Neurology

Volume 6, Issue 3, May–June 1990, Pages 147-150
Pediatric Neurology

Review article
Treatment of infantile spasms

https://doi.org/10.1016/0887-8994(90)90054-5Get rights and content

Abstract

Although the syndrome of infantile spasms has been known for 150 years and its treatment described since 1958, controversy still surrounds the appropriate therapy for this devastating disorder. The rationale, dosage, and side effects of ACTH treatment of infantile spasms is described. The recommended treatment regimen is placed in the context of the literature on the therapy of spasms and its relation to outcome.

References (37)

  • PM Jeavons et al.

    Infantile spasms: A review of the literature and a study of 112 cases

  • JR Lacy et al.

    Infantile spasms

  • PM Jeavons et al.

    Long term prognosis of 150 cases of “West syndrome”

    Epilepsia

    (1973)
  • GL Holmes

    Diagnosis and management of seizures in children

  • JG Millichap et al.

    Infantile spasms, hypsarrhythmia, and mental retardation

    JAMA

    (1962)
  • CT Lombroso

    A prospective study of infantile spasms. Clinical and therapeutic correlations

    Epilepsia

    (1983)
  • R Riikonen et al.

    ACTH therapy in infantile spasms: Side effects

    Arch Dis Child

    (1980)
  • I McQuarrie et al.

    Observations on the antagonistic effects of posterior pituitary and cortico-adrenal hormones in the epileptic subject

    J Clin Endocrinol Metab

    (1942)
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