[Epileptic encephalopathy with continuous spikes and waves during sleep (CSWS): a review]

Area of Science:

• Neurology
• Pediatric Epilepsy
• Sleep Medicine

Context:

• Epileptic encephalopathy with continuous spikes and waves during sleep (CSWS) is a rare, age-dependent neurological disorder affecting children.
• It presents with seizures, neurocognitive regression, and specific EEG patterns during sleep.
• This condition impacts approximately 0.5% of children and adolescents with epilepsy, typically emerging between 2-4 years of age.

Purpose:

• To define the characteristics and stages of CSWS.
• To outline treatment goals focusing on seizure control and reduction of EEG epileptiform activity.
• To identify effective therapeutic agents for CSWS.

Summary:

• CSWS is characterized by a triad of seizures, neurocognitive regression, and continuous spikes and waves during sleep (CSWS) on EEG.
• The condition progresses through distinct stages: dormant, prodromal, acute, and residual.
• EEG findings in CSWS can be focal, multifocal, unilateral, asymmetric, or symmetric bilateral and diffuse.

Impact:

• Effective management of CSWS requires addressing both clinical symptoms and EEG abnormalities.
• Benzodiazepines and steroids have demonstrated significant efficacy in treating CSWS.
• Early diagnosis and intervention are crucial for potentially reversing aspects of this encephalopathy.