In a case report of monozygotic twins with infantile spasms, ACTH resulted in more rapid clinical and EEG improvement compared to clonazepam.
Case report suggests possible ACTH advantage in infantile spasms; leaves open need for randomized trials before practice change.
The infantile spasms syndrome appeared on the same day in a pair of monozygotic twins at age 6 months. Clinical, electroencephalographic, and neuroradiological findings during the development of the disease are reported. One of the twins was treated with ACTH and in his case clinical and electroencephalographic improvement was more rapid than in the other who was treated with clonazepam. While the computer tomography scan initially showed in each twin an area of low density in the right fronto-parietal region, this had disappeared in the tomograms obtained about 8 months later.
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Pavone et al. (1980) studied this question.
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