Cranial Computed Tomography (CCT) Findings in Children Treated with ACTH and Dexamethasone: First Results

Abstract

8 children with different petit mal epilepsies were systematically treated with ACTH and dexamethasone. CCT examinations were performed before, during and after treatment. In all children severe cerebral changes. enlargement of ventricles and subarachnoid space developed during the initial phase of treatment with Depot-ACTH. Similar changes, but to a less severe degree, could be demonstrated during the phase of dexamethasone therapy thereafter. In all patients cerebral changes disappeared after hormonal treatment had ended. At this point many children had a developmental spurt, developmental relapses could not be observed. It is suggested that these reversible changes seen on CCT scans represent a form of morphological plasticity of brain structures. These results bear certain consequences as to the therapy of cerebral edema.

Brain tissue volume segmentation in patients with anorexia nervosa before and after weight normalization

“…Further support is provided by studies of patients with Cushing's disease, patients on long-term corticosteroid therapy, and children receiving adrenocorticotropic hormone (ACTH) for medication-refractory epilepsy who have also demonstrated widening of the cortical sulci, enlarged ventricles, or both (Bentson, Reza, Winter, & Wilson, 1978;Lagenstein, Willig, & Kü hne, 1979;Momose, Kjellberg, & Kliman, 1971;Okuno, Ito, Konishi, Yoshioka, & Nakano, 1980). However, steroids may reduce vascular permeability and promote water and sodium diuresis and thus produce dehydration (Bentson et al, 1978).…”

Cushing's disease due to an unusually large adenoma of the pituitary gland in infancy

“…Similar changes have been found in children with epilepsia treated with high ACTH doses [6]. The pathogenesis of this phenomenon is not yet clear.…”

Steroids and brain atrophy in multiple sclerosis

“…This hypothesis has been confirmed by experimental studies that examined electrolyte balance and changes of osmolarity in humans [26,30]. Lagenstein et al [19] followed 8 children with different types of petit mal epilepsy who were treated systematically with adrenocorticotropic hormone (ACTH) or dexamethasone for a period ranging from 5 months to 12 years. Computerized tomography (CT) examinations were performed before, during and after treatment.…”