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Response to clobazam in continuous spike-wave during sleep
Clemente Vega1, Ivan Sánchez Fernández2,3, Jurriaan Peters2
1Neurology/Psychiatry, Boston Children's Hospital/Harvard Medical School, Boston, MA, USA.
Developmental Medicine and Child Neurology
|November 24, 2017
Summary
Clobazam treatment improved verbal IQ in children with continuous spike-wave during sleep. While epileptiform discharges reduced, cognitive improvements varied, highlighting the need for further research.
Area of Science:
- Neuroscience
- Clinical Neurology
- Pediatric Epilepsy
Background:
- Continuous spike-wave during slow wave sleep (CSWS) is an epilepsy syndrome affecting children.
- CSWS is associated with cognitive deficits and behavioral problems.
- Effective treatments for CSWS are crucial for improving patient outcomes.
Purpose of the Study:
- To assess clobazam's efficacy in reducing epileptiform discharges in CSWS patients.
- To evaluate the impact of clobazam on neuropsychological function in children with CSWS.
- To explore the relationship between changes in epileptiform activity and cognitive outcomes.
Main Methods:
- A prospective clinical trial was conducted on 9 children (aged 4-10 years) with CSWS.
- Patients underwent electroencephalographic (EEG) monitoring and neuropsychological assessments before and after 3 months of clobazam treatment.
- Clobazam dosage was initiated at 1mg/kg (max 30mg) and maintained at 0.5mg/kg nightly.
Main Results:
- A qualitative reduction in spike percentage on EEG was observed after 3 months of clobazam treatment (72.2% to 32.7%).
- Overall IQ showed no significant change, but Verbal IQ qualitatively increased (83.0 to 95.0).
- Non-verbal IQ qualitatively decreased (84.0 to 71.0), indicating varied cognitive effects.
Conclusions:
- Short-term clobazam treatment led to qualitative improvements in epileptiform activity and verbal IQ in children with CSWS.
- Neuropsychological improvements were patient-specific, with some cognitive gains observed despite changes in epileptiform discharges.
- Larger studies are needed to further investigate the relationship between epileptiform activity and cognitive outcomes in CSWS treated with clobazam.
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