Baram T Z, Mitchell W G, Snead O C, Horton E J, Saito M
Department of Neurology, University of Southern California, Los Angeles.
Neurology. 1992 Jun;42(6):1171-5. doi: 10.1212/wnl.42.6.1171.
Massive infantile spasms (MIS), a seizure disorder unique to infants, is considered an age-dependent response of the immature brain to various insults and stressors. The seizures improve with ACTH and glucocorticoids, both major components of the brain-adrenal axis. We hypothesized that CNS levels of these hormones are abnormal in infants with MIS and studied CSF from 14 infants with MIS and 13 age-matched controls by analysis for corticotropin-releasing hormone (CRH), ACTH, cortisol, and interleukin-1-beta. ACTH levels in CSF of patients were significantly lower than those of controls, but differences in cortisol levels between patients and controls were not statistically significant. CRH levels in both groups were similar and fluctuated diurnally. These results indicate an alteration of specific CNS components of the brain-adrenal axis in MIS.
大规模婴儿痉挛症（MIS）是一种婴儿特有的癫痫障碍，被认为是未成熟大脑对各种损伤和应激源的年龄依赖性反应。癫痫发作会随着促肾上腺皮质激素（ACTH）和糖皮质激素改善，这两者都是脑-肾上腺轴的主要组成部分。我们假设患有MIS的婴儿这些激素的中枢神经系统水平异常，并通过分析促肾上腺皮质激素释放激素（CRH）、ACTH、皮质醇和白细胞介素-1-β，研究了14例患有MIS的婴儿和13例年龄匹配的对照组婴儿的脑脊液。患者脑脊液中的ACTH水平显著低于对照组，但患者和对照组之间皮质醇水平的差异无统计学意义。两组的CRH水平相似且呈昼夜波动。这些结果表明MIS中脑-肾上腺轴的特定中枢神经系统成分发生了改变。
