Klein Pavel, Sahoo Sanjiv
Georgetown University Hospital, Washington, DC, USA.
Epilepsy Behav. 2005 Mar;6(2):187-90. doi: 10.1016/j.yebeh.2004.11.010.
We assess the effect of acute hypercortisolemia induced by ACTH stimulation on seizures and EEG interictal spike activity in patients with localization-related epilepsy (LRE) and stress-related seizures.
Seven patients (3 males, 4 females) with LRE and stress-related seizures were studied. All patients underwent ACTH stimulation with 0.25-0.75 mg Cosyntropin intravenously at 8 am. Serum cortisol and ACTH levels were monitored half- to one-hourly for 4 to 6 hours. Video/EEG monitoring was also performed.
ACTH injection induced hypercortisolemia in all patients. Hypercortisolemia was not associated with seizures or interictal spike facilitation in any patient. Two patients experienced seizures on the day of ACTH injection, one 8 hours after and another 15 and 12 hours after the injection, during a period when their cortisol levels had returned to normal.
No reproducible interictal EEG changes occurred in any of the patients following ACTH injection.
我们评估促肾上腺皮质激素（ACTH）刺激诱导的急性高皮质醇血症对定位相关癫痫（LRE）和应激相关癫痫患者癫痫发作及脑电图发作间期棘波活动的影响。
对7例LRE和应激相关癫痫患者（3例男性，4例女性）进行研究。所有患者于上午8点静脉注射0.25 - 0.75mg考的松龙进行ACTH刺激。每半小时至一小时监测血清皮质醇和ACTH水平，持续4至6小时。同时进行视频/脑电图监测。
ACTH注射诱导所有患者出现高皮质醇血症。高皮质醇血症与任何患者的癫痫发作或发作间期棘波增强均无关联。2例患者在ACTH注射当天出现癫痫发作，1例在注射后8小时，另1例在注射后15小时和12小时，此时他们的皮质醇水平已恢复正常。
ACTH注射后，所有患者均未出现可重复的发作间期脑电图变化。
