Acth Gel is a highly purified preparation of adrenocorticotropic hormone (ACTH) in a gel that is design to provide extend release of the ACTH following injection. ACTH stimulates the adrenal cortex gland to secrete cortisol, corticosterone, and aldosterone. ACTH is a first-line treatment for infantile spasms, but it is also used in Lennox-Gastaut syndrome, Landau-Kleffner syndrome, and electrical status epilepticus in sleep. Improvement in seizure control can be seen even in the most difficult-to-control epilepsy after treatment with ACTH.