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Continuous Spikes and Waves during Sleep: Electroclinical Presentation and Suggestions for Management

Continuous spikes and waves during sleep (CSWS) is an epileptic encephalopathy characterized in most patients by (1) difficult to control seizures, (2) interictal epileptiform activity that becomes prominent during sleep leading to an electroencephalogram (EEG) pattern of electrical status epileptic...

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Autores principales: Sánchez Fernández, Iván, Chapman, Kevin E., Peters, Jurriaan M., Harini, Chellamani, Rotenberg, Alexander, Loddenkemper, Tobias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748771/
https://www.ncbi.nlm.nih.gov/pubmed/23991336
http://dx.doi.org/10.1155/2013/583531
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author Sánchez Fernández, Iván
Chapman, Kevin E.
Peters, Jurriaan M.
Harini, Chellamani
Rotenberg, Alexander
Loddenkemper, Tobias
author_facet Sánchez Fernández, Iván
Chapman, Kevin E.
Peters, Jurriaan M.
Harini, Chellamani
Rotenberg, Alexander
Loddenkemper, Tobias
author_sort Sánchez Fernández, Iván
collection PubMed
description Continuous spikes and waves during sleep (CSWS) is an epileptic encephalopathy characterized in most patients by (1) difficult to control seizures, (2) interictal epileptiform activity that becomes prominent during sleep leading to an electroencephalogram (EEG) pattern of electrical status epilepticus in sleep (ESES), and (3) neurocognitive regression. In this paper, we will summarize current epidemiological, clinical, and EEG knowledge on CSWS and will provide suggestions for treatment. CSWS typically presents with seizures around 2–4 years of age. Neurocognitive regression occurs around 5-6 years of age, and it is accompanied by subacute worsening of EEG abnormalities and seizures. At approximately 6–9 years of age, there is a gradual resolution of seizures and EEG abnormalities, but the neurocognitive deficits persist in most patients. The cause of CSWS is unknown, but early developmental lesions play a major role in approximately half of the patients, and genetic associations have recently been described. High-dose benzodiazepines and corticosteroids have been successfully used to treat clinical and electroencephalographic features. Corticosteroids are often reserved for refractory disease because of adverse events. Valproate, ethosuximide, levetiracetam, sulthiame, and lamotrigine have been also used with some success. Epilepsy surgery may be considered in a few selected patients.
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spelling pubmed-37487712013-08-29 Continuous Spikes and Waves during Sleep: Electroclinical Presentation and Suggestions for Management Sánchez Fernández, Iván Chapman, Kevin E. Peters, Jurriaan M. Harini, Chellamani Rotenberg, Alexander Loddenkemper, Tobias Epilepsy Res Treat Review Article Continuous spikes and waves during sleep (CSWS) is an epileptic encephalopathy characterized in most patients by (1) difficult to control seizures, (2) interictal epileptiform activity that becomes prominent during sleep leading to an electroencephalogram (EEG) pattern of electrical status epilepticus in sleep (ESES), and (3) neurocognitive regression. In this paper, we will summarize current epidemiological, clinical, and EEG knowledge on CSWS and will provide suggestions for treatment. CSWS typically presents with seizures around 2–4 years of age. Neurocognitive regression occurs around 5-6 years of age, and it is accompanied by subacute worsening of EEG abnormalities and seizures. At approximately 6–9 years of age, there is a gradual resolution of seizures and EEG abnormalities, but the neurocognitive deficits persist in most patients. The cause of CSWS is unknown, but early developmental lesions play a major role in approximately half of the patients, and genetic associations have recently been described. High-dose benzodiazepines and corticosteroids have been successfully used to treat clinical and electroencephalographic features. Corticosteroids are often reserved for refractory disease because of adverse events. Valproate, ethosuximide, levetiracetam, sulthiame, and lamotrigine have been also used with some success. Epilepsy surgery may be considered in a few selected patients. Hindawi Publishing Corporation 2013 2013-08-06 /pmc/articles/PMC3748771/ /pubmed/23991336 http://dx.doi.org/10.1155/2013/583531 Text en Copyright © 2013 Iván Sánchez Fernández et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Sánchez Fernández, Iván
Chapman, Kevin E.
Peters, Jurriaan M.
Harini, Chellamani
Rotenberg, Alexander
Loddenkemper, Tobias
Continuous Spikes and Waves during Sleep: Electroclinical Presentation and Suggestions for Management
title Continuous Spikes and Waves during Sleep: Electroclinical Presentation and Suggestions for Management
title_full Continuous Spikes and Waves during Sleep: Electroclinical Presentation and Suggestions for Management
title_fullStr Continuous Spikes and Waves during Sleep: Electroclinical Presentation and Suggestions for Management
title_full_unstemmed Continuous Spikes and Waves during Sleep: Electroclinical Presentation and Suggestions for Management
title_short Continuous Spikes and Waves during Sleep: Electroclinical Presentation and Suggestions for Management
title_sort continuous spikes and waves during sleep: electroclinical presentation and suggestions for management
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3748771/
https://www.ncbi.nlm.nih.gov/pubmed/23991336
http://dx.doi.org/10.1155/2013/583531
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