Takuma Y
Division of Neurology, Tokyo Metropolitan Kiyose Children's Hospital, Japan.
Epilepsia. 1998;39 Suppl 5:42-5. doi: 10.1111/j.1528-1157.1998.tb05149.x.
Combination therapy consisting of high-dose pyridoxal phosphate (40-50 mg/kg/day) and low-dose synthetic ACTH (0.01 mg/kg/day) was prescribed in 28 children with infantile spasms. Monotherapy with pyridoxal phosphate provided excellent seizure control in 3 of the 28 (11%) patients. ACTH was subsequently added to the regimen of the remaining 25 patients. As of 1 month after discontinuing the ACTH treatment, 21 of the 25 (84%) patients had experienced no seizures. The mean interval until seizure control was achieved was 4.1 days after the start of treatment with ACTH. The 21 patients have been monitored for a mean of 34.9 months (range 2-81 months); 6 patients (29%) have had recurrences of infantile spasms, and 10 (48%) have experienced normal development. Fourteen of the 28 patients (50%) have had transient increases in liver enzymes, but none of the patients developed more serious side effects.
对28例婴儿痉挛症患儿采用高剂量磷酸吡哆醛（40 - 50毫克/千克/天）和低剂量合成促肾上腺皮质激素（0.01毫克/千克/天）联合治疗。28例患者中有3例（11%）仅用磷酸吡哆醛单药治疗即实现了癫痫的良好控制。随后，对其余25例患者的治疗方案中加入了促肾上腺皮质激素。截至促肾上腺皮质激素治疗停止1个月时，25例患者中有21例（84%）未再发作。开始使用促肾上腺皮质激素治疗后，平均4.1天实现癫痫控制。对这21例患者平均随访了34.9个月（范围2 - 81个月）；6例患者（29%）婴儿痉挛症复发，10例患者（48%）发育正常。28例患者中有14例（50%）出现肝酶短暂升高，但无一例出现更严重的副作用。
