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[Neuropsychiatric abnormalities and continuous spikes and waves during slow sleep syndrome: a case report]
F Ducuing1, M F LeHeuzey, V Rouyer
1Service de psychopathologie de l'enfant et de l'adolescent, hôpital Robert-Debré, AP-HP, 48, boulevard Serrurier, 75019 Paris, France.
Insights
Continuous spikes and waves during slow wave sleep syndrome (CSWS) is a rare epilepsy. Early EEG diagnosis and treatment with antiepileptics and speech therapy can improve neurocognitive and behavioral outcomes.
Area of Science:
- Neurology
- Pediatric Epilepsy
- Neurophysiology
Background:
- Continuous spikes and waves during slow wave sleep syndrome (CSWS) is a rare epileptic disorder.
- CSWS can present with neurocognitive and psychiatric issues, sometimes without overt seizures.
Observation:
- A 5-year-old child with language and behavioral problems underwent EEG.
- Initial EEG showed localized spikes; continuous EEG revealed diffuse spike-wave discharges during sleep, diagnosing CSWS.
- Cerebral imaging ruled out other serious conditions.
Findings:
- Antiepileptic medication and speech therapy led to positive outcomes.
- EEG normalization correlated with partial neuropsychological improvement.
- CSWS diagnosis is crucial even without clinical seizures in complex cases.
Implications:
- Early EEG is vital for diagnosing CSWS in children with unexplained language and behavioral disorders.
- Combined antiepileptic and speech therapy is recommended for managing CSWS.
- Prompt diagnosis and treatment can significantly improve patient outcomes.
Unlabelled:
Continuous spikes and waves during slow wave sleep syndrome (CSWS) is a seldom form of epilepsy which may manifest by neurocognitive and/or psychiatric abnormalities, with or without clinical seizures.
Case Report:
A 5-year-old child was presented with a language disorder and behaviour abnormalities. A standard electroencephalograph (EEG) showed left tempororolandic spikes waves without any electrical discharges. Cerebral imaging excluded an underlying expansive disease. A continuous EEG recording revealed a CSWS syndrome by showing continuous and diffuse spike waves during slow wave sleep. Thanks to antiepileptic medications and orthophonic therapy, evolution was positive.
Conclusion:
In complex cases of language and behavioural disorders, it is necessary to perform an EEG even in the absence of convulsive seizures, to diagnose a CSWS syndrome. Given the etiological and treatment difficulties concerning the CSWS, a treatment with antiepileptic seems necessary. EEG normalisation under antiepileptic medications usually leads to significant, although partial, neuropsychological improvement. Furthermore, orthophonic therapy seems useful as a complement to pharmacological treatment.
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