[Circadian rhythm of cortisol under ACTH and dexamethasone therapy of convulsions in early childhood (BNS- and Lennox-syndrome) (author's transl)].

Convulsions in early childhood were treated successfully in a long term and high dosage regime with depot corticotrophin (80-120 IU/die) and dexamethasone (0.3 mg/kg/die). Depot-beta1-23corticotrophin stimulated, dexamethasone suppressed plasma cortisol levels, which, accordingly, ceased to show circadian rhythms. If dexamethasone was given alternately (every second day) and in a reduced dose (0.1 mg/kg) plasma cortisol levels increased, and if dosage was reduced again to 0.05 mg/kg cortisol levels showed circadian rhythms comparable to those before therapy. There was no disturbance of the hypothalamic--pituitary--adrenal system at the end of therapy. Considering experimental results in animals corticotrophin peptides and dexamethasone molecules might have a direct effect on the brain as far as cerebral convulsions are concerned. Because of serious side effects of steroids during treatment it seems to be worth while to try corticotrophin fragments, which had similar effects on the brain as beta1-24corticotrophin in animals, but without stimulating the adrenals.