Thyrotropin-releasing hormone: role in the treatment of West syndrome and related epileptic encephalopathies

Thyrotropin-releasing hormone (TRH) has been successfully used for treating children with neurologic disorders including epilepsy. The effectiveness of TRH and a TRH analog has been reported in West syndrome, Lennox–Gastaut syndrome, and early infantile epileptic encephalopathy that were intractable...

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Bibliographic Details
Published in:Brain & development (Tokyo. 1979) 2001-11, Vol.23 (7), p.662-667
Main Authors: Takeuchi, Yoshihiro, Takano, Tomoyuki, Abe, Junko, Takikita, Shoichi, Ohno, Masaki
Format: Article
Language:English
Subjects:
Biological and medical sciences
Cerebrospinal fluid
Child
Epilepsy - drug therapy
Epilepsy - physiopathology
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
Hormones. Endocrine system
Humans
Infant
Kynurenine
Kynurenine - physiology
Lennox–Gastaut syndrome
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
Pharmacology. Drug treatments
Spasms, Infantile - drug therapy
Spasms, Infantile - physiopathology
Thyrotropin-releasing hormone
Thyrotropin-Releasing Hormone - therapeutic use
West syndrome
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Summary:Thyrotropin-releasing hormone (TRH) has been successfully used for treating children with neurologic disorders including epilepsy. The effectiveness of TRH and a TRH analog has been reported in West syndrome, Lennox–Gastaut syndrome, and early infantile epileptic encephalopathy that were intractable to anticonvulsants and adrenocorticotrophic hormone (ACTH). However, the peptide has not been widely studied as a treatment of intractable epilepsy outside Japan. TRH is safe in children and effective in some cases of West syndrome and Lennox–Gastaut syndrome. TRH is considered as a possible new strategy for treating West syndrome and Lennox–Gastaut syndrome prior to ACTH therapy, especially for the patient with an infection, immunosuppression, or severe organic lesions in the brain. The mechanisms of its antiepileptic action may differ from those of other antiepileptic drugs. One possibility is that TRH may act as an antiepileptic through a kynurenine mechanism, considering that kynurenic acid acts as an antagonist on the N-methyl- d-aspartate receptor complex.
ISSN:0387-7604
1872-7131
DOI:10.1016/S0387-7604(01)00303-5