Spike-Wave Index Assessment and Electro-Clinical Correlation in Patients with Encephalopathy Associated with Epileptic State During Slow Sleep (ESES / CSWS); Single-Center Experience

Öztoprak, Ülkühan; Köken, Özlem Yayıcı; Aksoy, Erhan; Yüksel, Deniz

doi:10.1016/j.eplepsyres.2021.106549

Cited by 17 publications

(22 citation statements)

References 40 publications

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“…According to the results of the survival analysis, although the probability of ESES resolution of children diagnosed with ESES at ≥ 7.3 years of age was higher than that of children diagnosed with ESES at < 7.3 years of age after PER add-on treatment (73.8% vs. 34.6%, p = 0.008), no statistically significant difference in the therapeutic effect was found (64.3% vs. 43.6%, p = 0.166) when the patients were grouped according to the age of add-on PER initiation (≥9.8 years vs. < 9.8 years), indicating that an earlier age at disease onset corresponds to a worse response to the drug, but not due to older children are more likely to have selflimited ESES. Unlike previous studies (Öztoprak et al, 2021;van den Munckhof et al, 2015), MRI abnormalities did not lead to differences in the treatment results, which may be related to the milder MRI changes in our enrolled children. Cox multivariate regression results showed that an ESES duration > 2 years before add-on PER initiation was a risk factor for treatment failure, which is also consistent with previous reports demonstrating that prolonged discharge affects synaptic plasticity and causes abnormal neural circuit formation, which indicates that ESES may require more aggressive treatment.…”

Section: Discussioncontrasting

confidence: 78%

Effectiveness of perampanel in the treatment of pediatric patients with focal epilepsy and ESES: A single-center retrospective study

Teng²,

Liu³

et al. 2022

Front. Pharmacol.

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Objective: To investigate the therapeutic effect and influencing factors of perampanel (PER) on electrical status epilepticus during sleep (ESES).Methods: We retrospectively analyzed the clinical data of pediatric patients with focal epilepsy and ESES who were treated at the Epilepsy Center of Shengjing Hospital of China Medical University between January 2016 and March 2022. Changes in the spike wave index (SWI) after 24 weeks of PER add-on treatment were compared. Kaplan‒Meier survival analysis, the log-rank test and multivariate Cox regression analysis were performed.Results: A total of 54 pediatric patients met the inclusion criteria, including 33 males and 21 females. The mean age at the diagnosis of epilepsy was 6.41 ± 2.14 years and at ESES diagnosis was 7.58 ± 2.40 years. The mean ESES duration before add-on PER was 25.31 ± 15.12 months. The mean age of the patients at add-on PER initiation was 9.69 ± 2.12 years. The ESES resolved in 29 children after 6 months of PER add-on treatment, and the response rate was 53.7%. Univariate analysis with the log-rank test showed that the therapeutic effect of PER differed according to the age at ESES diagnosis and ESES duration before add-on PER treatment. Multivariate Cox regression analysis showed that only ESES duration before PER administration was a risk factor for PER treatment failure, and the other factors had no effect on the therapeutic effect.Conclusion: PER add-on treatment has a good therapeutic effect on ESES and can be used as an alternative to corticosteroid and benzodiazepines. The therapeutic effect of PER add-on treatment was not related to the dose. A longer ESES duration results in a worse therapeutic effect. Therefore, more aggressive treatment measures should be implemented for ESES.

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Section: Discussioncontrasting

confidence: 78%

Effectiveness of perampanel in the treatment of pediatric patients with focal epilepsy and ESES: A single-center retrospective study

Teng²,

Liu³

et al. 2022

Front. Pharmacol.

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“…Exclusion criteria: (1) complicated with an epileptic syndrome (e.g., Lennox-Gastaut syndrome, West syndrome), [11][12][13] (2) complicated with other serious diseases (e.g., severe hepatic or renal insufficiency, severe heart failure), and (3) patients who could not follow standard treatment or treatment protocols used by the authors.…”

Section: Methodsmentioning

confidence: 99%

“…The EEG outcomes were : Effective, the ESES mode disappeared or the SWI improved by ≤50%; ineffective, the SWI improved by <50%. We used the following formula to calculate the total effectiveness EEG rate 11 :

Total EEG effectiveness rate goodbreak= \frac{the number of children with effective EEG outcome}{total number of children} goodbreak\times 100

…”

Section: Methodsmentioning

confidence: 99%

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The prospective study of 54 children with electrical status epilepticus during sleep: How to simplify the electroencephalogram diagnosis and guide the treatment

Zhang

Yan

Peng

et al. 2023

Epileptic Disorders

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ObjectiveTo simplify the electroencephalogram (EEG) diagnosis and guide the treatment of electrical status epilepticus during sleep (ESES).MethodsWe recruited 54 children with ESES from December 2019 to December 2020 and compared various spike–wave index (SWI) calculation methods. Time‐frequency analysis assessed the correlation between high‐frequency oscillations energy and the SWI. We divided 42 children into responder and non‐responder treatment groups based on the observations made during a 12‐month follow‐up period and evaluate different treatment and the independent risk factors of refractory ESES.ResultsThe SWI of 5 min before the second sleep cycle of non‐rapid eye movement (NREM; long method II) and that of all NREM sleep (total method) were not significantly different (p = .06). The average energy of γ (r = .288, p = .002) and ripple (r = .203, p = .04) oscillations were correlated with the SWI. Multivariable logistic regression analysis showed that encephalomalacia was an independent risk factor for refractory ESES (OR: 10.48, 95% CI: 1.62–67.63). The clinical seizure improvement rates of anti‐seizure medications (ASMs), ASMs with benzodiazepines, and ASMs with benzodiazepines and steroids after 12 months were 9.3%, 42.8%, and 53.8%, EEG improvement rate were 5.5%, 30.9% and 37%, respectively. The intelligence of the children in the responder treatment group has improved during the 1‐year follow‐up.SignificanceThese findings demonstrate EEG and clinical features of ESES and may provide basis for simplifying diagnosis and guiding the treatment of children with ESES.

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“…Studies on SWI in the 50–85% range are still lacking, and its clinical significance has not been clearly defined. However, recent studies demonstrated that even RE patients with SWI between 50 and 85% suffered from failure of monotherapy and a poor long-term prognosis of cognitive function ( Oztoprak et al, 2021 ; Ucar et al, 2022 ). Recently, it has been noted that RE patients with SWI ≥ 50% perform significantly worse on arithmetic calculations, executive functions, attention and memory tests than children with SWI < 50% ( Zhang J. et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Alterations in the default mode network in rolandic epilepsy with mild spike-wave index in non-rapid eye movement sleep

Wang

Jiang

et al. 2022

Front. Neurosci.

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PurposeRolandic epilepsy (RE) is one of the most common epilepsy syndromes during childhood. The aim of this study was to investigate the alterations in the default mode network (DMN) of RE patients whose spike-wave index (SWI) was within the 50–85% range during non-rapid eye movement (NREM) during sleep, as well as to detect early neuroimaging markers.MethodsResting-state data was recorded for each subject using magnetoencephalography (MEG). DMN-related brain regions were chosen as regions of interest. The spectral power and functional connectivity (FC) of the DMN were estimated through the use of minimum norm estimation (MNE) combined with Welch technique and corrected amplitude envelope correlation (AEC-c).ResultsThe patient group included 20 patients with NREM phase 50% ≤ SWI < 85% (mild SWI group), and 18 typical RE patients (SWI < 50% group). At the regional level, the mild SWI group exhibited enhanced spectral power in the delta band of the bilateral posterial cingulate cortex and attenuated the spectral power in the alpha band of the bilateral posterial cingulate cortex. Enhanced spectral power in the bilateral precuneus (PCu) in the delta band and attenuated spectral power in the right lateral temporal cortex (LTC) in the alpha band were common across all RE patients. At the FC level, patients in the mild SWI group indicated increased AEC-c values between the bilateral posterial cingulate cortex in the delta band and between the left medial frontal cortex (MFC) and bilateral posterial cingulate cortex in the alpha band. Increased AEC-c values between the right PCu and left MFC in the delta band, and between the left PCu and right MFC in the theta band, were common across all RE patients. Moreover, the spectral power in the bilateral posterial cingulate cortex in the alpha band and the AEC-c value between the bilateral posterial cingulate cortex in the delta band demonstrated good discrimination ability.ConclusionThe spectral power of the bilateral posterior cingulate cortex (PCC) in the alpha band and the AEC-c value between the bilateral PCC in the delta band may be promising indicators of early differentiation between mild SWI and typical RE.

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Spike-Wave Index Assessment and Electro-Clinical Correlation in Patients with Encephalopathy Associated with Epileptic State During Slow Sleep (ESES / CSWS); Single-Center Experience

Cited by 17 publications

References 40 publications

Effectiveness of perampanel in the treatment of pediatric patients with focal epilepsy and ESES: A single-center retrospective study

Effectiveness of perampanel in the treatment of pediatric patients with focal epilepsy and ESES: A single-center retrospective study

The prospective study of 54 children with electrical status epilepticus during sleep: How to simplify the electroencephalogram diagnosis and guide the treatment

Alterations in the default mode network in rolandic epilepsy with mild spike-wave index in non-rapid eye movement sleep

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