Abstract
Adrenocorticotropic hormone (ACTH) and corticoids represent the first-line treatment of the infantile spasms-West syndrome. The exact cellular and network mechanisms behind the anti-epileptic effect of ACTH and corticoids are not known.
In the brain, these substances display multiple effects ranging from controlling inflammation, brain maturation, and cellular proliferation to the modulation of several neurotransmitter systems. ACTH and corticoids display multiple systemic effects on the body mainly on glucose metabolism and immune system.
Therefore, their administration is associated with increased risk of severe side effects. ACTH and steroids display nearly identical efficacy in controlling infantile spasms.
The popularity of corticoids in the treatment of infantile spasms is increasing due to their advantages which include oral route of administration, lower risk of side effects, and low cost. Apart from infantile spasms, corticoids are also used in the treatment of other epileptic syndromes in childhood including Lennox-Gastaut syndrome, Landau-Kleffner syndrome, or electrical status epilepticus in sleep syndrome.