The Effect Of Short Course ACTH In The Treatment Of60Cases Of Infant Spasms And Its Influencing Factors

Objective: To summarize the effect after treatment of small dose andshort course ACTH with60cases of infant spasms, and analyze the influencefactors of the effect and prognosis, and the assessment of the relationshipbetween the cessation of spasms and change of EEG, providing thetheoretical evidence for treatment and prognosis judgment.Methods: The database of60cases of infant spasms in the firstaffiliated hospital of guangxi medical university were reviewed from2008to2013, with gender, age, age of onset, duration, psychomotordevelopment, family epilepsy history, etiology,EEG and brain imaging, thespasms remission rate and disappearance of hypsarrhythmia after4weeks,were observed with retrospective studies. Following up to36casesby clinic or telephone.Results:(1) A total of60cases of infant spasm,the age of onset of less than6months accounted for51.6%(31/60), more than6months accounted for48.4%(29/60).The lead time which is less than months accounted for38.3%, more than2months accounted for61.6%. symptoms accounted for73.3%, cryptogenic accounted for26.7%. In the symptomatic group27casesof prenatal factors,17cases of perinatal or postnatal factors. (2)After4weeks of ACTH treatment, among60diagnosed infantilespasms,37cases(61.6%) were remission of spasms,20cases(33.3%) free of spasms..Taking ACTH as the preferred treatment in14cases,46cases of non preferred.comparison between groups with efficiency, the results showed that ACTH as the drug of choice in treatment group was significantly higher than that of non preferred efficiency group (P <0.05).(3)After4weeks of ACTH treatment, the total effective rate was61.7%,EEG recovery rate was41.7%。(4) With chi-square test on the treated with ACTH count data betweeneffective and ineffective group (gender, etiology, age, family history,age, course of treatment,) is analyzed.And according to these threefactors group more efficiently, P value is less than0.05, between groupswas statistically significant.(5)36cases were followed up, the time last from1to6years. Theseizure control and neurodevelopment of infantile spasms of cryptogenicgroup were better than those of symptomatic group, There are significantdifferences between cryptogenic group and symptomatic group inlongterm seizure control and neurodevelopmen.Conclusion:1. After4weeks of ACTH treatment, the total effective rate was61.7%,EEG recovery rate was41.6%. Results show that small dose (25u) ACTH, shortcourse (4weeks) and effective treatment. 2.ACTH as the preferred treatment, opportunity ofwithout seizures greater than using other antiepileptic drugs, from anegative to support ACTH as the preferred treatment for IS.3. The younger age of onset,expicit or suspected causesof disease, the longer lead time have poor effect after ACTH treatment..4. Expicit or suspected causes of disease may have poor prognosis.