ACTH levels in CSF of 14 infants with massive infantile spasms were significantly lower than those of controls in a study from the University of Southern California and Childrens Hospital of Los Angeles, CA. Differences in Cortisol levels between patients and controls were not statistically significant. The authors postulate the involvement of the corticotropin-releasing hormone-ACTH-glucocorticoid regulatory loop in the pathophysiology of infantile spasms. 
COMMENT. Further studies of this type should help to determine the respective merits of low dose versus high dose ACTH therapy in infantile spasms.