Role of ACTH in Infantile Spasms

Infantile Spasms are brief episodes of seizure in an infant and is usually associated with West Syndrome. It usually occurs between 4 to 12 months of age and usually resolves by 2 years. Hence the mainstay of treatment is to control the seizures.

Adrenocorticotropic hormone (ACTH), a peptide hormone secreted by the anterior pituitary acts on the adrenal gland to release cortisol and androgens. ACTH injections are used for rapid and complete elimination of infantile spasms.  

Mechanism of action of ACTH in Infantile spasms is based on –  

  • common excitatory pathway : Increased (CRH) synthesis in limbic system activates the native stress system of brain and causes seizures. ACTH decreases the production and release of CRH (Corticotropin hormone) in limbic system.  
  • direct influence on limbic neurons via the recently characterized melanocortin receptors.
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