Maekawa K, Ohta H, Tamai I
Neuropadiatrie. 1980 Feb;11(1):80-4. doi: 10.1055/s-2008-1071378.
This is the report of two cases of infantile spasms, manifesting transient brain shrinkage in computerized tomography (CT) after ACTH treatment. ACTH was given for 8 weeks to a 8-months-old Japanese girl with infantile spasms. First CT performed at 2 weeks after the final ACTH injection, displayed moderate brain shrinkage. Second CT at 4 months showed marked diminution of the shrinkage. ACTH was also given for 8 weeks to a 14 months old Japanese boy with infantile spasms. First CT, just before ACTH treatment, showed mild cortical atrophy, the second at 7 days after the final ACTH injection revealed marked brain shrinkage and moderate ventricular dilatation, and the third at 2 months, disclosed mild improvement of the shrinkage. ACTH or corticoateroid has widespread effects on the developing nervous system. In animal experiments, ACTH or steroids interfere with brain growth of young rats. CT findings of transient brain shrinkage in a child with infantile spasms might suggest that intensive treatment with ACTH or steroids in infancy interferes with brain growth as seen in the results of animal experiments.
本文报告了两例婴儿痉挛症病例，在促肾上腺皮质激素（ACTH）治疗后，计算机断层扫描（CT）显示出现短暂性脑萎缩。一名8个月大的日本患婴儿痉挛症女孩接受了8周的ACTH治疗。在最后一次注射ACTH两周后进行的首次CT检查显示中度脑萎缩。4个月时的第二次CT检查显示萎缩明显减轻。一名14个月大的患婴儿痉挛症日本男孩也接受了8周的ACTH治疗。ACTH治疗前的首次CT检查显示轻度皮质萎缩，最后一次注射ACTH 7天后的第二次CT检查显示明显脑萎缩和中度脑室扩张，2个月时的第三次CT检查显示萎缩有轻度改善。ACTH或皮质类固醇对发育中的神经系统有广泛影响。在动物实验中，ACTH或类固醇会干扰幼鼠的脑生长。婴儿痉挛症患儿出现短暂性脑萎缩的CT表现可能表明，婴儿期使用ACTH或类固醇进行强化治疗会干扰脑生长，这与动物实验结果一致。
