cosyntropin and Seizures

We assess the effect of acute hypercortisolemia induced by ACTH stimulation on seizures and EEG interictal spike activity in patients with localization-related epilepsy (LRE) and stress-related seizures.. Seven patients (3 males, 4 females) with LRE and stress-related seizures were studied. All patients underwent ACTH stimulation with 0.25-0.75 mg Cosyntropin intravenously at 8 am. Serum cortisol and ACTH levels were monitored half- to one-hourly for 4 to 6 hours. Video/EEG monitoring was also performed.. ACTH injection induced hypercortisolemia in all patients. Hypercortisolemia was not associated with seizures or interictal spike facilitation in any patient. Two patients experienced seizures on the day of ACTH injection, one 8 hours after and another 15 and 12 hours after the injection, during a period when their cortisol levels had returned to normal.. No reproducible interictal EEG changes occurred in any of the patients following ACTH injection.

Topics: Adolescent; Adrenal Cortex Function Tests; Adrenocortical Hyperfunction; Adult; Cosyntropin; Dose-Response Relationship, Drug; Electroencephalography; Epilepsy; Female; Humans; Hydrocortisone; Male; Middle Aged; Seizures; Stress, Physiological; Time Factors

A 6 year-old Chinese boy with Kabuki syndrome presented with hypoglycemic seizure. He was diagnosed to have isolated adrenocorticotropin deficiency. To our knowledge, this is the first case of Kabuki syndrome with isolated adrenocorticotropin deficiency in the literature.

Topics: Abnormalities, Multiple; Adrenocorticotropic Hormone; Child; Corticotropin-Releasing Hormone; Cosyntropin; Dermatoglyphics; Fingers; Hormones; Humans; Hypoglycemia; Hyponatremia; Intellectual Disability; Male; Seizures; Syndrome; Water-Electrolyte Imbalance

We present the cases of three women who, within a 6-month period, suffered post-partum generalized tonic-clonic seizures. All had received an epidural in labour for analgesia and were subsequently diagnosed as suffering from postdural puncture headache. All were treated for that headache with Synacthen and one also received sumatriptan before her seizures. All made satisfactory recoveries and were discharged home. None displayed classical patterns suggestive of pre-eclampsia, meningitis, cortical venous thrombosis or any other pathological process that might explain these events adequately, and the specific precipitating factors were left unidentified.

Topics: Adult; Analgesia, Epidural; Anesthesia, Obstetrical; Cosyntropin; Female; Headache; Humans; Seizures; Spinal Puncture; Sumatriptan