Effects of ACTH on brain midline structures in infants with infantile spasms

Changes of the midline structures of the brain, including the pons, cerebellar vermis, and corpus callosum, induced by adrenocorticotropic hormone (ACTH) therapy in 7 infants with infantile spasms were investigated using magnetic resonance imaging. Decreased volume of these parts of the brain was induced in almost all infants. Decreased volume of the pons was thought to be closely related to sleep disturbance during ACTH therapy. These results may demonstrate that the cessation of convulsive episodes in infants with infantile spasms treated with ACTH is due to its direct action on the brainstem.