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Abstract Details

Assessment of adrenal function after ACTH treatment in children with infantile spasms: a retrospective analysis of local practices and trends
Child Neurology and Developmental Neurology
Child Neurology and Developmental Neurology Posters (7:00 AM-5:00 PM)
090
Our goals with this study were to: a) assess how often endocrinology was involved in patient care; b) identify predictors of hypsarrhythmia persistence on EEG following ACTH. 
Infantile spasms (IS) is an age dependent epileptic encephalopathy.  Treatment with high dose ACTH suppresses the hypothalamic-pituitary-adrenal axis necessitating stress-steroid therapy during intercurrent infections/illnesses after ACTH treatment. 
We performed a five year retrospective chart review of all children admitted to a tertiary Childrens Hospital diagnosed with infantile spasms and treated with ACTH. 
Of the 23 patients with infantile spasms, 10 underwent cosyntropin testing under the care of an endocrinologist.  Of those, 80% of tests were done more than 3 months after completion of ACTH therapy, and 6 passed cosyntropin stimulation test.  Female gender and the presence of modified hypsarrhythmia on pre-ACTH EEG had a higher incidence of persistent hypsarrhythmia following ACTH. Patients with symptomatic and cryptogenic IS had 67% and 69% incidence of developmental delay. Patients with symptomatic IS had a higher incidence of delays after ACTH treatment (89%) versus the cryptogenic group (69%; p=0.17).  
Our study demonstrates the need for a multi-disciplinary team, involving endocrinology, in the care of patients with IS. Though not statistically significant, we noted a trend of an increase in incidence of developmental delay following ACTH therapy in the symptomatic IS sub-population, which should be explored in future studies. 
Authors/Disclosures
Babitha Haridas, MBBS (UBMD Neurology)
PRESENTER 		Dr. Haridas has nothing to disclose.
Mohammad N. Haider (University At Buffalo, SUNY) Mr. Haider has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Blink TBI. Mr. Haider has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Blink CNS. Mr. Haider has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Oculogica Inc. Mr. Haider has stock in Headquarters Health. The institution of Mr. Haider has received research support from NIH. Mr. Haider has received research support from Headquarters Health. The institution of Mr. Haider has received research support from CDMRP/PRMRP.
No disclosure on file
Osman Farooq, MD (University at Buffalo) Dr. Farooq has nothing to disclose.