乳幼児前屈型小発作に対するACTH-Z療法

ACTH-Z THERAPY OF FLEXOR SPASMS IN INFANCY

序言

　乳幼児前屈型小発作＊＊は，発病年齢，発作像，脳波所見など種々の特徴あるてんかんの一発作型であるが，特に乳幼児の精神運動機能発達に深甚な影響を及ぼすこと，及びかくの如く予後重篤なるに拘らず，特に有効な治療法が存在しなかつたことから，本発作型の治療は，小児神経病学に携わるものにとつて，最大の関心事の1つであつた。著者らは，さきにPhenuroneが，又後にGemonilが，本発作型に対し，かなり有効であつたことを報告した^2）3）。一方Sorel et Dusau-cy-Bauloye^5）は，1957年Brusselsで行われた国際神経病学会に於て，ACTHが，本発作型に劇的効果のあることを報告して以来，Gibbs^6）7）ら，Low^8），Gastautら^9）の追試がいち早くなされ，何れもACTHの卓効を認めている。しかしこれら著者の報告は，何れも10例未満の少数例に関してであつた。私達は半信半疑ながらこれら驚異的方法を早速とりあげ，更に多数の症例に応用し，従来の治療法にみられないすぐれた効果を確認し得たのでここに報告する。

Resumé Administering ACTH-Z therapy to 56 cases of flexor spasms of infancy, we obtained the excellent results as follows.

(1) Clinical seizures were entirely abol-ished in 12 cases, and distinctly diminished in other 17 cases after one course of treat-ment which was consisted from 8 injections of ACTH-Z 10 units each time.

(2) In 42 cases, serial electroencephalo-graphy were recorded immediately before and after the treatment. Highly abnormal ep-ileptic discharges with hypsarhythmia as the central figure disappeared perfectly in 9 ca-ses, and ameliorated remarkably in 20 cases.

(3) The changes in behavior such as im-proved motor ability, increased awareness, re-appearance of social smile and shyness, were observed in patients corresponding with clini-cal and electroencephalographic ameliorations.

(4) These effects of ACTH became evident in general within a few days after the start of treatment and lasted during periods varing from one to seven months. Relapse of sei-zures occurred in 9 cases, but most of these were well responded again to the second course of ACTH injections.