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Electrophysiological patterns and therapeutic outcomes in DEE-SWAS: A cohort study from a tertiary pediatric

Fatma Hanci1, Ayşegül Daniş2

  • 1Division of Child Neurology, Department of Pediatrics, Kanuni Education and Training Hospital, Trabzon University Medical School, Trabzon, Turkey.

Epileptic Disorders : International Epilepsy Journal with Videotape
|February 9, 2026
PubMed

Insights

Early reduction in spike-wave index (SWI) in pediatric patients with developmental and epileptic encephalopathy with SWAS indicates a better prognosis. Persistent high SWI and abnormal EEG activity predict long-term neurological impairment.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Clinical Electrophysiology

Background:

  • Developmental and epileptic encephalopathy with spike-wave activation during sleep (DEE-SWAS) is a severe condition in children.
  • Understanding prognostic factors is crucial for effective management of DEE-SWAS.

Purpose of the Study:

  • To characterize clinical, electrophysiological, and radiological features of pediatric DEE-SWAS.
  • To identify predictors of prognosis in children with DEE-SWAS.

Main Methods:

  • Retrospective cohort study of 25 pediatric patients with DEE-SWAS and a spike-wave index (SWI) ≥50%.
  • Analysis of clinical, EEG, and neuroimaging data over a minimum 2-year follow-up.
  • Assessment of factors associated with residual neurological or electrophysiological abnormalities.

Main Results:

  • Patients with residual findings showed higher SWI at 3, 6, and 24 months (p<0.05).
  • Lower EEG background frequency and higher amplitude during wakefulness were observed in those with residual findings (p<0.05).
  • Abnormal neurological examination correlated significantly with residual findings (p=0.02).

Conclusions:

  • A significant early reduction in SWI is linked to a better prognosis in pediatric DEE-SWAS.
  • Persistent elevated SWI and abnormal background EEG activity predict long-term neurological deficits.
  • Early identification and tailored treatment are vital for managing DEE-SWAS.
Abstract

Keywords:
DEE‐SWASEEGESESepileptic encephalopathypediatric neurologyspike–wave index

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