Thyrotropin-releasing hormone in treatment of intractable epilepsy: Neurochemical analysis of CSF monoamine metabolites

Takeuchi, Yoshihiro; Tominaga, Masashi; Mitsufuji, Nobuto; Yamazoe, Ichiro; Kawase, Syouji; Nishimura, Akira; Matsuo, Satoshi; Sawada, Tadashi

« Previous Next »Pediatric Neurology
Volume 12, Issue 2 , Pages 139-145, February 1995

Thyrotropin-releasing hormone in treatment of intractable epilepsy: Neurochemical analysis of CSF monoamine metabolites☆

Yoshihiro Takeuchi, MD
- Communication should be addressed to: Dr. Takeuchi; Department of Pediatrics, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamikyo-ku; Kyoto 602, Japan.
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Japan
Masashi Tominaga, MD
- Department of Pediatrics, Kyoto Municipal Hospital, Japan
Nobuto Mitsufuji, MD
- Department of Pediatrics, Kyoto First Red Cross Hospital, Kyoto, Japan
Ichiro Yamazoe, MD
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Japan
Syouji Kawase, MD
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Japan
Akira Nishimura, MD
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Japan
Satoshi Matsuo, MD
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Japan
Tadashi Sawada, MD
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Japan

Received 19 September 1994; accepted 12 December 1994.

Abstract

The efficacy of thyrotropin-releasing hormone in children with intractable epilepsy was investigated and changes in cerebrospinal fluid monoamine metabolites were analyzed. The 18 patients had either West syndrome (12 patients) or Lennox-Gastaut syndrome (6 patients), which was intractable to antiepileptic drug therapy and to adrenocorticotrophic hormone. Thyrotropin-releasing hormone-tartrate was administered for 4 weeks. Before and after the thyrotropin-releasing hormone administration, cerebrospinal fluid was collected and analyzed for 5-hydroxyindoleacetic acid, kynurenine, homovanillic acid, and 3-methoxy-4-hydroxyphenyl glycol. The patients were classified into 3 groups, based on seizure frequency and electroencephalographic effects: cessation of seizures and seizure discharges (very effective; group A), reduction of seizures and/or seizure discharges (effective; group B), and no changes in frequency of seizures or discharges (not effective; group C). There were 6 patients in group A, 3 in group B, and 9 in group C. There were no significant differences in monoamine metabolites before and after the thyrotropin-releasing hormone therapy. A trial of thyrotropin-releasing hormone for the treatment of intractable epilepsy is warranted and further study is required on the mechanism of the antiepileptic action of thyrotropin-releasing hormone.

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