Decisive evidence of direct effect of ACTH treatment in West syndrome: A case report

In patients with West syndrome, the administration of exogenous adrenocorticotropic hormone (ACTH) is considered a potent and effective treatment [1]. Exogenously administered ACTH hyperactivates the hypothalamic-pituitary-adrenal axis (Fig. 1A); however, the resulting hormonal changes cannot fully account for the therapeutic effect of ACTH. Indeed, the administration of corticosteroids to patients with West syndrome failed to provide an anti-epileptic effect comparable to that of ACTH [1]. Thus, the antiepileptic effect of ACTH in West syndrome has been postulated to involve a direct action of ACTH on the central nervous system (i.e., a “direct pathway”) that occurs independently of the hypothalamic-pituitary-adrenal axis (i.e., an “indirect pathway”).

Source: Seizure: European Journal of Epilepsy - May 24, 2021 Category: Neurology Authors: Marie Sasaki, Toshiki Takenouchi, Yuri Sakaguchi, Takao Takahashi Source Type: research