The efficacy of ACTH, particularly in high doses, for rapid and complete elimination of
infantile spasms (IS) has been demonstrated in prospective controlled studies. However, the
mechanisms for the efficacy remain unknown. ACTH promotes the release of adrenal
steroids (glucocorticoids), and most ACTH effects on the central nervous system have been
attributed to activation of glucocorticoid receptors. The manner in which activation of these
receptors improves IS and the basis for the enhanced therapeutic effects of ACTH …