Nalin A, Petraglia F, Genazzani A R, Frigieri G, Facchinetti F
Department of Pediatrics, University of Modena, Italy.
Childs Nerv Syst. 1988 Dec;4(6):365-6. doi: 10.1007/BF00270612.
In a previous study we found depressed ACTH and normal beta-endorphin values in the cerebrospinal fluid of patients with West's syndrome, whereas normal peptide levels were present in infants with secondary Infantile spasms. This prompted us to study the effects of naloxone administration in children with West's syndrome. After informed consent was obtained from the parents, the effects of naloxone administration on clinical and EEG findings were evaluated in five infants 5-9 months old (3 males, 2 females) with cryptogenic infantile spasms and hypsarrhythmia. The infants were studied at the onset of symptomatology before therapy. An average of 5-10 groups of spasms were present per day. Naloxone (12 micrograms/kg body weight) was administered as an intravenous bolus in two cases, as a slow venous drip in another two cases, and intramuscularly in the last case. EEG and polygraphic monitoring were performed for 2 h. Naloxone did not induce any acute behavioral changes and the number of seizures remained unchanged after treatment. These data reject the possibility that endogenous opioids tonically modulate infantile spasms. Further studies are required to ascertain the involvement of POMC peptides in West's syndrome.
在先前的一项研究中，我们发现韦斯特综合征患者脑脊液中的促肾上腺皮质激素（ACTH）水平降低，而β-内啡肽水平正常，而继发性婴儿痉挛症婴儿的肽水平正常。这促使我们研究纳洛酮给药对韦斯特综合征患儿的影响。在获得家长的知情同意后，对5名5至9个月大（3名男性，2名女性）患有隐源性婴儿痉挛症和高度节律失调的婴儿，评估了纳洛酮给药对临床和脑电图结果的影响。这些婴儿在症状出现之初且未接受治疗时接受研究。每天平均出现5至10组痉挛。2例婴儿静脉推注纳洛酮（12微克/千克体重），另外2例缓慢静脉滴注，最后1例肌肉注射。进行了2小时的脑电图和多导记录仪监测。纳洛酮未引起任何急性行为变化，治疗后癫痫发作次数未变。这些数据排除了内源性阿片类物质对婴儿痉挛症进行紧张性调节的可能性。需要进一步研究以确定阿片促黑激素皮质素原（POMC）肽在韦斯特综合征中的作用。
