THYROTROPIN-RELEASING-HORMONE IN TREATMENT OF INTRACTABLE EPILEPSY - NEUROCHEMICAL ANALYSIS OF CSF MONOAMINE METABOLITES

The efficacy of thyrotropin-releasing hormone in children with intract able epilepsy was investigated and changes in cerebrospinal fluid mono amine metabolites were analyzed, The 18 patients had either West syndr ome (12 patients) or Lennox-Gastaut syndrome (6 patients), which was i ntractable to antiepileptic drug therapy and to adrenocorticotrophic h ormone. Thyrotropin-releasing hormone-tartrate was administered for 4 weeks, Before and after the thyrotropin-releasing hormone administrati on, cerebrospinal fluid was collected and analyzed for 5-hydroxyindole acetic acid, kynurenine, homovanillic acid, and 3-methoxy-4-hydroxyphe nyl glycol, The patients were classified into 3 groups, based on seizu re frequency and electroencephalographic effects: cessation of seizure s and seizure discharges (very effective; group A), reduction of seizu res and/or seizure discharges (effective; group B), and no changes in frequency of seizures or discharges (not effective; group C), There we re 6 patients in group A, 3 in group B, and 9 in group C, There were n o significant differences in monoamine metabolites before and after th e thyrotropin-releasing hormone therapy, A trial of thyrotropin-releas ing hormone for the treatment of intractable epilepsy is warranted and further study is required on the mechanism of the antiepileptic actio n of thyrotropin-releasing hormone.