부산대학교 도서관

We studied relationship between initial and long-term effects of ACTH therapy in 37 patients with refractory childhood epilepsy. The response to ACTH was evaluated both by the time necessary for seizure cessation from the initiation of ACTH and by the improvement of epileptic discharges in EEG during the ACTH therapy. Seizures ceased in 25 patients, relapsed in 2, and persisted in 10 during the ACTH therapy. There was no relationship between the time from starting ACTH to cessation of seizures and the relapse of seizures after the ACTH therapy. Among 25 patients who became free of seizures, those with no epileptic discharges (11) showed favorable outcome compared to those with focal, multifocal or diffuse epileptic discharges (14) in EEG during ACTH. Out of the 11 patients with no epileptic discharges, 6 patients were free of seizures and only one showed recurrent seizures within 1 year after the ACTH therapy. On the other hand, only 3 patients were free of seizures and 9 showed recurrence of seizures within 1 year after the ACTH therapy in 14 patients with persistent epileptic discharges during the ACTH therapy. These results suggest that EEG findings have a predictive value of long-term seizure prognosis of refractory childhood epilepsy treated by ACTH. We also discussed the prognostic value of EEG findings after the daily ACTH treatment for the first 2 weeks according to Fukuyama's original method of ACTH therapy.