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I feel sorry for the child. As I was reading the post, I was shocked to read that he died.
It is true that ACTH treatment can worsen the cortical atrophy. In a study of 26 children with Infantile spasms, three showed progressive cortical atrophy with ACTH treatment.
In another study, they have described a particular type of syndrome, which is a cause of West syndrome, to be associated with progressive cortical atrophy.
But I was wondering if the cause of death was pneumonia or something else.
I guess, you can consider the combination of West syndrome, ACTH and pneumonia as the culprits.
Regards