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Epileptic encephalopathy with continuous spike and wave during sleep associated to periventricular leukomalacia

Elisa De Grandis1, Maria Margherita Mancardi2, Valentina Carelli3

  • 1Child Neuropsychiatry Unit, Istituto Giannina Gaslini, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children's Sciences, University of Genoa, Genoa, Italy elisa.degrandis@unige.it.

Journal of Child Neurology
|December 3, 2013
PubMed

Insights

Epilepsy affects 31% of children with periventricular leukomalacia (PVL), a common brain injury in premature infants. Continuous spike-waves during sleep syndrome, linked to poor outcomes, warrants early EEG monitoring for intervention.

Area of Science:

  • Neurology
  • Pediatrics
  • Neonatology

Background:

  • Periventricular leukomalacia (PVL) is the leading cause of brain injury in premature infants.
  • Epilepsy is a known complication of various brain injuries in children.

Purpose of the Study:

  • To determine the frequency and characteristics of epilepsy in children with PVL.
  • To identify associations between epilepsy and clinical features in this population.

Main Methods:

  • Retrospective analysis of 137 children diagnosed with PVL.
  • Evaluation of epilepsy prevalence, seizure types, and specific epilepsy syndromes.
  • Correlation analysis with neonatal seizures, neurological deficits, and cognitive outcomes.

Main Results:

  • Epilepsy was present in 31% (42/137) of children with PVL.
  • West syndrome occurred in 12% and continuous spike-waves during slow sleep (CSWS) in 19% of epilepsy cases.
  • CSWS was associated with unfavorable outcomes, including increased seizure frequency and drug resistance.
  • Epilepsy showed significant associations with neonatal seizures, spastic tetraplegia, and mental retardation.

Conclusions:

  • Epilepsy is a significant complication in children with PVL, though less common than in other brain injuries.
  • The frequent occurrence of CSWS in this cohort highlights the need for vigilance.
  • Electroencephalographic (EEG) sleep monitoring is crucial for early diagnosis and treatment of epilepsy in PVL patients to prevent neurological decline.

Keywords:
cerebral palsypreterm birthsleep-potentiated epileptiform activity

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