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Response (absence of both hypsarrhythmia and spasms) to prednisolone was ascertained by repeat overnight video\u2010\n                      <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content>\n                      . Responders were tapered over 2\u00a0weeks and nonresponders were immediately transitioned to high dose (150\u00a0IU\/m\n                      <jats:sup>2<\/jats:sup>\n                      \/day) intramuscular adrenocorticotropic hormone (\n                      <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content>\n                      ) for two additional weeks. Response was again determined by overnight video\u2010\n                      <jats:styled-content style=\"fixed-case\">EEG<\/jats:styled-content>\n                      after\n                      <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content>\n                      therapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Findings<\/jats:title>\n                    <jats:p>\n                      Sixty\u2010three percent (17\/27) of patients responded completely to prednisolone. Subsequently, 40% (4\/10) of prednisolone nonresponders exhibited a complete response after an additional 2\u2010week course with\n                      <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content>\n                      . Among 27 subjects with median follow\u2010up of 13.5\u00a0months (interquartile range [IQR] 4.8\u201325.9), 12% (2\/17) of prednisolone responders and 50% (2\/4) of\n                      <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content>\n                      responders experienced a relapse between 2 and 9\u00a0months after initial response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>\n                      Very high dose prednisolone demonstrated significantly higher efficacy than previously reported for lower doses in prior studies. High dose\n                      <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content>\n                      may be superior to very high dose prednisolone, and in lieu of a definitive clinical trial, the choice between prednisolone and\n                      <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content>\n                      for initial treatment of infantile spasms remains controversial.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.12460","type":"journal-article","created":{"date-parts":[[2013,11,8]],"date-time":"2013-11-08T08:52:49Z","timestamp":1383900769000},"page":"103-107","source":"Crossref","is-referenced-by-count":76,"title":["Treatment of infantile spasms with very high dose prednisolone before high dose adrenocorticotropic hormone"],"prefix":"10.1111","volume":"55","author":[{"given":"Shaun A.","family":"Hussain","sequence":"first","affiliation":[{"name":"Division of Neurology Department of Pediatrics Mattel Children's Hospital and David Geffen School of Medicine at UCLA Los Angeles California U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shlomo","family":"Shinnar","sequence":"additional","affiliation":[{"name":"Departments of Neurology, Pediatrics, and Epidemiology and Population Health Montefiore Medical Center Albert Einstein College of Medicine Bronx New York U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Kwong","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Pediatrics Mattel Children's Hospital and David Geffen School of Medicine at UCLA Los Angeles California U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason T.","family":"Lerner","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Pediatrics Mattel Children's Hospital and David Geffen School of Medicine at UCLA Los Angeles California U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce H.","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Pediatrics Mattel Children's Hospital and David Geffen School of Medicine at UCLA Los Angeles California U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joyce Y.","family":"Wu","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Pediatrics Mattel Children's Hospital and David Geffen School of Medicine at UCLA Los Angeles California U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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