Primary neonatal thalamic haemorrhage and epilepsy with continuous spike-wave during sleep: a longitudinal follow-up of a possible significant relation

Sleep-potentiated epileptiform activity in early thalamic injuries: Study in a large series (60 cases)

“…Neuropathological characteristics of the early perinatal brain damage (vascular mechanism involving the anterior choroidal artery in MCA ischemic infarction or thalamostriate vein area confluencing with terminal vein in venous haemorrhagic infarction) shown by neuroimaging account for the frequent, especially unilateral thalamic involvement (Guzzetta et al, 2005). It is thus confirmed the relevance for CSWS genesis of unilateral thalamic lesions as indicated by experimental (Steriade and Contreras, 1998) and clinical studies (Monteiro et al, 2001;Guzzetta et al, 2005;Issa, 2014).…”

“…An EEG paroxysmal activation during sleep may occur in children with early thalamic injuries as reported in sporadic cases (Incorpora et al, 1999;Kelemen et al, 2006;Monteiro et al, 2001) and in large series of early brain lesions involving thalamus, especially vascular in origin (Guzzetta et al, 2005;Sánchez Fernández et al, 2012a). The clinical syndrome (epilepsy with continuous spike-waves during slow wave sleep: CSWS*) 1 is an age-related epileptic encephalopathy acknowledged by the Commission on Classification and Terminology of the International League Against Epilepsy (1989) and is characterized by a combination of focal epilepsy, neurocognitive regression and an electroencephalographic pattern of electrical status epilepticus during sleep (ESES*).…”

Encephalopathy with status epilepticus during sleep: Unusual EEG patterns

“…7,8,12,[36][37][38] In some patients of our series with bilateral brain involvement slow waves were also found and therefore it may be interesting to determine the impact of this abnormal EEG activity in this period of sleep in developing deterioration. [22][23][24][25][26] As may occur in the classic ESES syndrome, markedly abnormal neuronal activity during a critical period for synaptogenesis may result in aberrant synapse formation, explaining this poor neuropsychological outcome. 12 The synaptic homeostasis hypothesis predicts that the strength of synapses is decreased during sleep.…”

“…[19][20][21] The syndrome may occur in children with structural brain lesions, such as unilateral polymicrogyria (PMG), hydrocephalus, and thalamic lesions. [21][22][23][24][25][26] Treatment of the ESES syndrome has frequently been disappointing, but different antiepileptic drug schemes have been proposed. 19,21,23,[27][28][29][30] In refractory cases, therapeutic alternatives such as corticosteroids, gamma-globulins, the ketogenic diet, and surgery have been tried.…”

Continuous Spike and Waves During Sleep and Electrical Status Epilepticus in Sleep

“…Several case reports describe patients with thalamic injury who developed CSWS or sleep potentitation of interictal epileptiform discharges (Incorpora et al, 1999;Monteiro et al, 2001). In a large series, 29 of the 32 patients with early thalamic lesions suffered from ESES or sleep activation of paroxysmal discharges.…”