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Revista del Cuerpo Médico Hospital Nacional Almanzor Aguinaga Asenjo
versão impressa ISSN 2225-5109versão On-line ISSN 2227-4731
Resumo
CAMPOS-OLAZABAL, Patricia; HURTADO-ROCA, Yamilee e MONTUFAR-CRESPOC, S. Marcela. Adrenocorticotropic hormone in patients with West syndrome and progression to Lennox-Gastaut syndrome. Rev. Cuerpo Med. HNAAA [online]. 2021, vol.14, n.4, pp.466-471. Epub 29-Dez-2021. ISSN 2225-5109. http://dx.doi.org/10.35434/rcmhnaaa.2021.144.1322.
Background:
This paper will evaluate the use of adrenocorticotropic hormone as a therapy modality for West syndrome and the time required for development of the severely progressive form of West syndrome (LGS, Lennox-Gastaut syndrome). There is little data on this condition for our population.
Material and Methods:
This is a cohort review in which 139 patient records were evaluated in two pediatric units in Lima, Peru; and they were analyzed between 2000 and 2010. All patients who met the following criteria were included in the study: massive spasms, delayed psychomotor development, and hypsarrhythmia in electroencephalogram (EEG) tracing. Adrenocorticotropic hormone was administered to a group of patients as post-diagnosis therapy. The follow-up period for these patients was 10 years.
Results:
The hazard ratio (HR) for progression to Lennox-Gastaut Syndrome in patients using adrenocorticotropic hormone was 0.45 (95% CI: 0.24-0.83, p= 0.011) compared to those without adrenocorticotropic hormone. Adjusted RR for progression to Lennox-Gastaut Syndrome for all variables studied (age of onset, sex, frequency of seizures, etiology, and time from diagnosis to therapy initiation) in patients who used adrenocorticotropic hormone was 0.56 (95% CI 0.29 to 0.08, P= 0.085) compared with those without adrenocorticotropic hormone.
Conclusions:
The use of adrenocorticotropic hormone in patients with West syndrome could protect against progression to Lennox-Gastaut syndrome. We consider this supports the evidence found in populations similar to ours, and we believe this finding could be confirmed with clinical trials.
Palavras-chave : Epilepsy; Lennox-Gastaut Syndrome; Adrenocorticotropic Hormone.