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Epilepsy with continuous spikes and wave during slow sleep: A case report

Surachai Likasitwattanakul1

  • 1Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. sisli@mahidol.ac.th

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|July 22, 2006
PubMed

Insights

Corticosteroids may help treat children with epilepsy and continuous spikes and waves during slow sleep (CSWS). This adjunctive treatment improved cognitive, behavioral, and language functions when standard drugs were insufficient.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Clinical Neuroscience

Background:

  • Epilepsy with continuous spikes and waves during slow sleep (CSWS) is a severe epileptic encephalopathy in children.
  • CSWS is characterized by frequent seizures, cognitive decline, and behavioral issues.
  • Standard antiepileptic drugs (AEDs) are the first-line treatment for CSWS.

Observation:

  • A 5.5-year-old girl presented with refractory seizures, cognitive deterioration, and language impairment.
  • Electroencephalography revealed continuous spike-wave discharges during slow-wave sleep, consistent with CSWS.
  • While conventional AEDs controlled her seizures, significant improvements in cognitive, behavioral, and language functions were not achieved.

Findings:

  • Adjunctive corticosteroid therapy was initiated for the patient with CSWS.
  • Following corticosteroid treatment, marked improvement in behavioral, cognitive, and language deficits was observed.
  • Seizure control was maintained with the addition of corticosteroids.

Implications:

  • Corticosteroids may represent a valuable adjunctive treatment for CSWS, particularly in cases refractory to standard AEDs.
  • This finding suggests a potential role for immunomodulatory therapies in managing the non-epileptic manifestations of CSWS.
  • Further research is warranted to elucidate the mechanisms and efficacy of corticosteroids in pediatric epilepsy syndromes like CSWS.

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