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NEUROLOGY 1992;42:1171
© 1992 American Academy of Neurology

Brain-adrenal axis hormones are altered in the CSF of infants with massive infantile spasms

T. Z. Baram, MD, PhD, W. G. Mitchell, MD, O. C. Snead, III, MD, E. J. Horton, MD and M. Saito, MD

Departments of Neurology and Pediatrics, University of Southern California; and the Division of Neurology, Childrens Hospital of Los Angeles, Los Angeles, CA.

Massive infantile spasms (MIS), a seizure disorder unique to infants, is considered an age-dependent response of the immature brain to various insults and stressors. The seizures improve with ACTH and glucocorticoids, both major components of the brain-adrenal axis. We hypothesized that CNS levels of these hormones are abnormal in infants with MIS and studied CSF from 14 infants with MIS and 13 age-matched controls by analysis for corticotropin-releasing hormone (CRH), ACTH, cortisol, and interleukin-1-beta. ACTH levels in CSF of patients were significantly lower than those of controls, but differences in cortisol levels between patients and controls were not statistically significant. CRH levels in both groups were similar and fluctuated diurnally. These results indicate an alteration of specific CNS components of the brain-adrenal axis in MIS.

Supported by NS01307 (Dr. Baram).

Address correspondence and reprint requests to Dr. Tallie Z. Baram, Division of Neurology (#82), CHLA, P.O. Box 54700, Los Angeles, CA 90054-0700.

Received August 22, 1991. Accepted for publication in final form November 25, 1991.




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