Advances in therapy of infantile spasms. Current knowledge of actions of ACTH and corticosteroids.

The anticonvulsant actions of ACTH and corticosteroids in the treatment of infantile spasms have been well documented during the past 29 years. In the past decade neuropeptides have been studied intensively and an understanding of their actions has been gained. Most of the actions of ACTH are well documented in animal experiments and cytochemical studies. Some proceedings of modern steroid research are here reviewed. In the treatment of infantile spasms, the principal mechanism of the therapeutic action of ACTH and corticosteroids is unknown. Clinical data concerning their effects, site and mode of action, on brain and CSF neurochemical activity are still scant and controversial. Some mechanisms probably involved in the therapeutic effects are reviewed. It seems that a disturbance of the central neural transmitter regulation at a specific phase of brain development may be the underlying cause for infantile spasms.