Wang Qiuhong, He Wen, Wang Yangyang, Liu Liying, Zhang Mengna, Yang Xiaoyan, Zou Liping
Department of Pediatrics Chinese PLA General Hospital The First Medical Center of Chinese PLA General Hospital Beijing China.
Department of Pediatrics, Beijing Institute for Brain Disorders, Center for Brain Disorders Research Capital Medical University Beijing China.
Pediatr Investig. 2023 Mar 9;7(1):29-35. doi: 10.1002/ped4.12368. eCollection 2023 Mar.
Infantile spasm (IS) is a kind of refractory epilepsy. The first-line treatments for IS are adrenocorticotropic hormone (ACTH), oral corticosteroids, and vigabatrin.
This study aimed to evaluate the efficacy of magnesium sulfate and ACTH (MgSO+ACTH) combination therapy in patients with IS who failed first-line treatments.
In this retrospective study, the clinical data of patients with IS who failed first-line treatments were collected in the Chinese PLA General Hospital. Patients received MgSO+ACTH combination therapy after first-line treatments failed. The course of treatments was 2 weeks. The therapeutic dose of ACTH and MgSO was 2.5 U·kg·d and 0.25 g·kg·d, respectively.
A total of 229 patients with IS who failed the first-line treatments were collected. At the end of the MgSO+ACTH combination treatment, the seizure-free rate was 48.5% (111/229), and the resolution of hypsarrhythmia on electroencephalogram (EEG) was 72.1% (165/229). About 21.4% (49/229) of patients showed side effects, including infectious diseases, hypokalemia, and diarrhea.
For patients with IS who failed first-line treatments, in terms of the seizure-free rate and resolution of hypsarrhythmia on EEG, MgSO+ACTH combination therapy can be considered.
婴儿痉挛症（IS）是一种难治性癫痫。IS的一线治疗方法是促肾上腺皮质激素（ACTH）、口服皮质类固醇和氨己烯酸。
本研究旨在评估硫酸镁与ACTH（MgSO+ACTH）联合治疗对一线治疗失败的IS患者的疗效。
在这项回顾性研究中，收集了中国人民解放军总医院一线治疗失败的IS患者的临床资料。患者在一线治疗失败后接受MgSO+ACTH联合治疗。疗程为2周。ACTH和MgSO的治疗剂量分别为2.5 U·kg·d和0.25 g·kg·d。
共收集到229例一线治疗失败的IS患者。在MgSO+ACTH联合治疗结束时，无癫痫发作率为48.5%（111/229），脑电图（EEG）高峰失律消失率为72.1%（165/229）。约21.4%（49/229）的患者出现副作用，包括传染病、低钾血症和腹泻。
对于一线治疗失败的IS患者，就无癫痫发作率和EEG高峰失律消失率而言，可考虑MgSO+ACTH联合治疗。
