Epilepsy with Continuous Spike-Waves during Slow Sleep: When and How Should We Treat?

Abstract

Epilepsy with continuous spike-waves during slow sleep (CSWS),which is one of the hallmarks of electrical status epilepticus during slow wave sleep (ESES), is a functional disorder with the following features: severe paroxysmal EEG disturbance; seizures that may be severe but self-limited; behavioral deterioration, with or without premorbid developmental disturbances; no demonstrable brain pathology sufficient to explain the behavioral deterioration; and stabilization or improvement of behavior once the epileptiform EEG abnormalities resolve [1]. Much serious in CSWS are cognitive and behavioral disturbances. In CSWS, paroxysmal activity permanently affects the frontal lobes and higher cognitive functions. At highest risk for permanent sequelae are those with the earliest and longest exposure to the active phase of CSWS. When and how should CSWS be treated?