Treatment Practices and Outcomes in Continuous Spike and Wave during Slow Wave Sleep: A Multicenter Collaboration.

Area of Science:

• Pediatric Neurology
• Epileptology
• Clinical Therapeutics

Background:

• Continuous spike and wave during slow wave sleep (CSWS) is a challenging epilepsy syndrome in children.
• Current management strategies for CSWS vary, necessitating a comparison of treatment effectiveness.

Purpose of the Study:

• To evaluate current management practices for CSWS across multiple pediatric epilepsy centers.
• To compare the efficacy of different treatment modalities for CSWS.

Main Methods:

• A retrospective analysis of 81 children with CSWS from 11 US epilepsy centers (2014-2016).
• Treatments were categorized into benzodiazepines, steroids, other antiseizure medications (ASMs), and other therapies.
• Treatment response was assessed by clinical and electroencephalography (EEG) improvement, controlling for baseline variables.

Main Results:

• Benzodiazepines and ASMs were the most common first-line therapies for CSWS.
• Benzodiazepines and steroids showed significantly higher odds of clinical improvement compared to ASMs.
• Steroids demonstrated a greater likelihood of EEG improvement than ASMs.

Conclusions:

• Antiseizure medications appear less effective for CSWS compared to benzodiazepines and steroids.
• Earlier consideration of benzodiazepines and steroids may be beneficial for treating CSWS.
• Further multicenter prospective studies are required to validate these findings and optimize treatment protocols.