Neuropsychiatric impairment in children with Continuous Spikes and Waves during slow Sleep: A long‐term follow-up study

What is more harmful, seizures or epileptic EEG abnormalities? Is there any clinical data?

“…Despite the impairment observed during the presence of active IIS, children with BECTS have no permanent effects of the IIS, with the vast majority of children having no residual cognitive impairment (Callenbach et al ., ). However, two related conditions which appear to be a continuum of BECTS, LKS and CSWS, have a substantially worse prognosis (Halasz et al ., ; Mikati and Shamseddine, ; Metz‐Lutz and Filippini, ; Margari et al ., ; Seegmuller et al ., ).…”

“…Despite the impairment observed during the presence of active IIS, children with BECTS have no permanent effects of the IIS, with the vast majority of children having no residual cognitive impairment (Callenbach et al, 2010). However, two related conditions which appear to be a continuum of BECTS, LKS and CSWS, have a substantially worse prognosis (Halasz et al, 2005;Mikati and Shamseddine, 2005;Metz-Lutz and Filippini, 2006;Margari et al, 2012;Seegmuller et al, 2012). LKS is a rare childhood disorder characterised by a loss or regression of previously acquired language and epileptiform discharges, involving the temporal or parietal regions of the brain (Landau and Kleffner, 1957;Cooper and Ferry, 1978;Hirsch et al, 1990;Beaumanoir, 1992).…”

Progressive intellectual impairment in children with Encephalopathy related to Status Epilepticus during slow Sleep

“…The majority of affected children never return to normal levels, particularly for verbal and attention abilities (Morikawa et al, 1985;Roulet Perez et al, 1993; see also Arzimanoglou and Cross, p. S71-5). Margari et al followed 25 patients (19 male) from 2 to 16 years of age (mean age: 6 years±3 SD) to examine the presence and course of neuropsychiatric disorder (mean duration of follow-up: 3.9 years) (Margari et al, 2012). At diagnosis of CSWS, 54% of patients had behavioral problems, 37.5% mental retardation, 33% learning disabilities, 17% developmental coordination disorder, 12.5% language disorder, and 8% pervasive developmental disorder.…”

Neuropsychological Outcome in Perinatal Stroke Associated With Epileptiform Discharges in Sleep

“…Continuous spike-wave in slow wave sleep (CSWS) is an epileptic encephalopathy featuring electrical status epilepticus in sleep (ESES) associated with delays or regression in language, cognitive, and behavioural function. 13 Many authors use the terms CSWS and ESES interchangeably, and the two descriptions are likely a spectrum of similar pathology. [14][15][16] Original descriptions of ESES defined the electroencephalogram (EEG) abnormality as a bilaterally symmetric spike and wave discharge that occupies at least 85% of slow wave sleep and that commonly occurs in preschool children.…”

“…17 Others have since recognized that focal or unilateral ESES and/or discharges present for less than 85% of the recording may also contribute to neurocognitive dysfunction. 13,14,18,19 The most recent, revised terminology on epilepsy by the International League Against Epilepsy does not list diagnostic criteria for CSWS/ESES, 20 and spike-wave index cutoffs continue to be debated. 18 ESES and similar syndromes have been described in children with early brain injuries, particularly of the thalamus, including neonatal deep sinovenous thrombosis and hemorrhagic stroke.…”