The short and long-term effects of adrenocorticotrophic hormone (ACTH) in 30 children ages 11 to 86 months (median 29 months) with epileptic spasms (ES) without hypsarrhythmia were analyzed at Tokyo Women’s Medical University, Japan. The short-term effect was excellent in 19 (63%) and poor in 11 (37%). Long-term (follow-up >1 year), 8 (29%) continued seizure free, whereas 9 had seizure recurrence. In 9 of the responders, EEG had changed from diffuse abnormality to a frontal focus. 
COMMENT. Significant improvement in language, cognition, and behavior is reported in 9 of 10 patients with Landau-Kleffner syndrome or CSWS treated with prednisone 1 mg/kg/day.