Abstract
We report the case of a 19 month old girl with myoclonic encephalopathy of infants (MEI) (Kinsbourne syndrome), on long-term therapy with ACTH for the occurrence of frequent relapses (steroid-dependent form). The administration of trazodone per os at low doses as an alternative to the previous treatment ensured complete remission, also on the occasion of a subsequent relapse. No rebound effects were observed after trazodone withdrawal (10 months). At present, 3 years after withdrawal of the therapy, the child is well and free from symptoms. The hypothesis that trazodone may be effective in treating MEI, at least in cases that are steroid-dependent or resistant to ACTH, appears highly interesting. Trazodone is proposed as a possible alternative to treatment with ACTH.
Sommario
Viene segnalato il caso di una bambina di 19 mesi affetta da encefalopatia mioclonica infantile (EMI) (Sindrome di Kinsbourne), in trattamento cronico con ACTH per le frequenti recidive (forma steroido-dipendente).
La somministrazione di trazodone per os, a basse dosi, in alternativa al trattamento precedente, ha consentito di ottenere la remissione completa, anche nel corso di una successiva ricaduta. La sospensione del trattamento (dopo 10 mesi) non si è associata a fenomeni di recidiva; attualmente, a 3 anni dalla sospensione, la bambina sta bene ed è libera da sintomi. Appare suggestiva l'ipotesi dell'efficacia del trazodone nella EMI, almeno in casi steroido-dipendenti o resistenti all'ACTH. Il trazodone viene proposto come possibile alternativa al trattamento con ACTH.
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Papini, M., Pasquinelli, A. & Filippini, A. Steroid-dependent form of Kinsbourne syndrome: successful treatment with trazodone. Ital J Neuro Sci 13, 369–372 (1992). https://doi.org/10.1007/BF02223106
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DOI: https://doi.org/10.1007/BF02223106