The Spike–Wave Index of the First 100 Seconds of Sleep Can Be a Reliable Scoring Method for Electrographic Status Epilepticus in Sleep

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Neil Kulkarni ◽  
Dara V. F. Albert ◽  
Brett Klamer ◽  
Michael Drees ◽  
Jaime D. Twanow
2019 ◽  
Vol 19 (03) ◽  
pp. 186-193
Author(s):  
Bernhard Schmitt

ZusammenfassungSchlaf und Epilepsie stehen in enger Beziehung zueinander. 20 % der Epilepsiepatienten erleiden Anfälle nur in der Nacht, 40 % nur am Tag und 35 % bei Tag und Nacht. Kinder mit Panayiotopoulos-Syndrom oder Rolando-Epilepsie erleiden ihre Anfälle vorwiegend im Schlaf und zeigen im NREM-Schlaf eine Zunahme der Spike-waves. ESES (elektrischer Status epilepticus im Schlaf) und Landau-Kleffner-Syndrom sind epileptische Enzephalopathien mit ausgeprägten kognitiven Einbrüchen, Verhaltensauffälligkeiten und Anfällen. Kennzeichnend ist eine kontinuierliche Spike-wave-Aktivität im NREM-Schlaf. Patienten mit juveniler Myoklonusepilepsie oder Aufwach-Grand-Mal-Epilepsie haben ihre Anfälle nach dem Aufwachen, nicht selten nach vorausgehendem Schlafentzug. Nächtliche Frontallappen-Anfälle werden oft mit Parasomnien verwechselt. Für eine korrekte Zuordnung ist es hilfreich, die klinische Symptomatik und die Häufigkeit pro Nacht und Monat in die Beurteilung mit einzubeziehen. Nächtliche Anfälle und Antikonvulsiva wirken sich auf den Schlaf aus. Schlafstörungen sollten erkannt und behandelt werden, da dies die Anfallskontrolle und Lebensqualität verbessern kann. Bei Verdacht auf Epilepsie und nicht schlüssigem Wach-EEG können Schlaf-EEGs hilfreich sein. Abhängig von der Fragestellung kann das EEG im Mittagsschlaf (natürlicher Schlaf oder medikamentös induziert), während der Nacht oder nach vorausgehendem Schlafentzug stattfinden.


2018 ◽  
Vol 35 (5) ◽  
pp. 370-374 ◽  
Author(s):  
Charuta N. Joshi ◽  
Kevin E. Chapman ◽  
Joshua J. Bear ◽  
Scott B. Wilson ◽  
Diana J. Walleigh ◽  
...  

2003 ◽  
Vol 03 (02) ◽  
pp. 64-66
Author(s):  
Dirk Heinicke ◽  
Andreas Merkenschlager ◽  
Fouad Chaaban

ZsuammenfassungWir berichten über ein 8-jähriges Mädchen, das ab dem dritten Lebensjahr eine Stagnation und schließlich einen Abbau besonders der sprachlichen Funktionen zeigte. Im Alter von 5 Jahren fielen klinisch atypische Abcencen auf. Im Wach-EEG wurde eine fast kontinuierliche SW-Tätigkeit gesehen und eine Valproat-Therapie begonnen. Diese führte zu einer vorübergehenden Besserung der kognitiven Entwicklung und des EEG‘s für einige Monate. Bei erneuter Verschlechterung wurde zur differenzialdiagnostischen Abklärung erstmalig im Alter von 7½ Jahren ein Langzeit-EEG durchgeführt und dadurch kontinuierliche Spike-wave-Entladungen im synchronisierten Schlaf (electrical status epilepticus during slow sleep, ESES oder auch kontinuierliche Spike-wave-Aktivität im Schlaf, CSWS) dokumentiert. Durch den konsekutiven Einsatz von zunächst Sultiam und dann Clobazam wurde eine – jeweils nur vorübergehende – Reduktion der hypersynchronen Aktivität und gleichzeitig eine signifikante Verbesserung in allen Entwicklungsbereichen erreicht.


2020 ◽  
Vol 105 ◽  
pp. 106965
Author(s):  
Natrujee Wiwattanadittakul ◽  
Dewi Depositario-Cabacar ◽  
Tesfaye G. Zelleke

2019 ◽  
Vol 8 (7) ◽  
pp. 992 ◽  
Author(s):  
Chih-Hsiang Lin ◽  
Chen-Jui Ho ◽  
Yan-Ting Lu ◽  
Fu-Yuan Shih ◽  
Yao-Chung Chuang ◽  
...  

Patients that survive status epilepticus (SE) may suffer from neurological and cognitive deficits that cause severe disabilities. An effective scoring system for functional outcome prediction may help the clinician in making treatment decisions for SE patients. Three scoring systems, namely the Status Epilepticus Severity Score (STESS), the Epidemiology-Based Mortality Score in Status Epilepticus (EMSE), and the Encephalitis-Nonconvulsive Status Epilepticus-Diazepam Resistance-Image Abnormalities-Tracheal Intubation (END-IT), have been developed in the past decade to predict the outcomes of patients with SE. Our study aimed at evaluating the effectiveness of these scores in predicting the function outcomes both at and after discharge in SE patients. We retrospectively reviewed the clinical data of 55 patients admitted to our neurological intensive care unit between January 2017 and December 2017. The clinical outcomes at discharge and at last follow-up were graded using the modified Rankin Scale. Our research indicated that STESS was the most sensitive and EMSE was the most specific predictive scoring method for SE outcome prediction. On the other hand, END-IT predicted functional outcomes in SE patients poorly. We concluded that STESS and EMSE can accurately predict the functional outcomes in SE patients both at discharge and the follow-up period.


Seizure ◽  
2014 ◽  
Vol 23 (3) ◽  
pp. 213-221 ◽  
Author(s):  
Palma Piros ◽  
Szilvia Puskas ◽  
Miklos Emri ◽  
Gabor Opposits ◽  
Tamas Spisak ◽  
...  

2014 ◽  
Vol 22 (2) ◽  
pp. 71-87 ◽  
Author(s):  
Peter Halász ◽  
Márta Hegyi ◽  
Zsuzsa Siegler ◽  
András Fogarasi

SUMMARYAim.The aim of this article is to review criticaly the Electrical Status Epilepticus in Slow Sleep (ESES) phenomenon from a neurophysiological mechanisms aspect as well as terminological and classification issues.Methods.The review includes all the relevant papers published during the last 43 years on the subject of ESES and Continous Spike – Wave in Sleep (CSWS).These papers were identified in various large databases via the internet.Rewiev and remarks.ESES/CSWS phenomena can be held as a common final pathway originating from different etiologies, including patients with early brain damage (probably involving thalamic structures), but also patients without structural pathology as in atypical evolution of idiopathic regional childhood hyperexcitability syndromes (with Rolandic epilepsy as a prototype). There are hints that genetic predisposition might be an important factor in the development of this process. The two large patient groups (lesional and non-lesional) show the same EEG evolution and encephalopathic cognitive consequences. The sleep EEG activation can be held as a common endophenotype. ESES represents an extreme sleep activation/potentiation of the local/regional interictal discharges, enhancing them in frequency, territorial extension, intra and trans-hemispherial propagation, synchrony and continuity. This process is most probably not identical with the development of bilateral spike-wave pattern in „generalized” epilepsies which involves primarily or secondarily the thalamocortical system as it had been explored by Gloor (1979) for idiopathic generalized rpilepsy and Steriade and Amzica (2003) for different types of generalized spike and wave discharges.Conclusions and syndromological embedding of ESES.In an overwhelming majority of the investigated cases, the maps of the single discharges constituting sleep activation are identical; with focal/regional interictal spikes followed by slow closing wave, as it is seen in childhood regional age dependent hyperexcitability syndromes (prototype of the centro-temporal spikes of Rolandic epilepsy). The main mechanism of the developing cognitive impairment is most probably the consequence of interference with plastic function of slow wave sleep by obliterating synaptic decline during sleep. Presently, the consensus and co-operative research is highly obstacled by the terminological chaos, the controversial definitions and views around this still striking and enigmatic phenomenon.


2022 ◽  
Vol 7 (1) ◽  
pp. 428
Author(s):  
Vatine Adila ◽  
Kurnia Kusumastuti ◽  
Sri Andreani Utomo

Status epileptikus (SE) merupakan kegawatan neurologis akibat kegagalan terminasi dari bangkitan dan juga hipereksitasi neuron sehingga menyebabkan bangkitan yang abnormal atau berkepanjangan. Mortalitas terkait SE terus mengalami peningkatan, terutama pada populasi geriatri. Hal ini menyebabkan SE menjadi penyakit dengan biaya pengobatan yang besar khususnya di negara-negara terbelakang dan berkembang. Pemahaman terkait elektroensefalogram (EEG) pada SE dapat membantu dalam penentuan diagnosis secara akurat dan pemberian terapi secara tepat. Penelitian ini bertujuan untuk mengetahui gambaran EEG pasien SE di Departemen Neurologi RSUD Dr. Soetomo. Penelitian dilakukan secara observasional deskriptif dengan desain studi potong lintang menggunakan data sekunder dari rekam medis pasien dengan diagnosis SE pada periode Januari 2016 – Desember 2019. Data pasien yang lengkap kemudian dilakukan analisis berdasarkan usia, jenis kelamin, etiologi, komorbid, tipe bangkitan, onset terjadinya SE, jarak waktu antara onset dengan pelaksanaan EEG, keadaan klinis, dan gambaran EEG. Hasil: Sebagian besar pasien SE dalam penelitian ini berjenis kelamin laki-laki dengan kelompok usia >1-10 tahun, diikuti kelompok usia >19-60 tahun. Etiologi SE terbanyak adalah meningoensefalitis, diikuti oleh epilepsi dan stroke. Populasi anak dan geriatri lebih rentan terhadap infeksi yang dapat menyebabkan SE, terutama di negara berkembang. Sebagian besar pasien tidak memiliki komorbid lain dan menjalani pemeriksaan EEG dalam waktu 3-<7 hari setelah bangkitan terakhir, dengan onset general sebagai onset SE yang dominan. SE konvulsif adalah jenis SE yang paling banyak dengan bangkitan general tonik-klonik sebagai manifestasi motorik terbanyak. Temuan EEG yang terbanyak adalah interiktal general diikuti oleh interiktal fokal. Sharp/spike wave dan continuous slow activity merupakan gambaran pelepasan epileptiform dan non-epileptiform terbanyak secara berurutan.  


2006 ◽  
Vol 64 (3b) ◽  
pp. 723-726 ◽  
Author(s):  
Gloria Maria Almeida Souza Tedrus ◽  
Lineu Corrêa Fonseca

To study clinical and EEG features of children with ictal vomiting and no underlying brain lesions (Panayiotopoulos syndrome). The subjects were 36 children aged 2-13 years. The onset of seizures occurred between 1 and 5 years of age. Fourteen children (38.8%) had a single seizure. Fourteen children (38.8%) had autonomic status epilepticus. Impairment of consciousness was reported in 30 (83.3%) children, eye deviation in 10 (27.7%) other autonomic symptoms and head deviation in 9, generalization in 8, visual symptoms in one child, and, speech arrest or hemifacial motor symptoms in 8 cases. The EEG showed occipital spikes or spike-wave complexes in 27 (75.0%) children, blocked by opening of the eyes in 8 (22.2%) cases. Nine patients (25%) also had rolandic spikes and 3 had extraoccipital spikes. Six (16.6%) patients had normal EEG. No clinical differences were observed between patients having occipital or extraoccipital spikes. In children only with autonomic seizures, the spikes are predominantly occipital but blockage by opening of the eyes is a less frequent feature. In some children there is an overlapping of different focal childhood idiopathic syndromes.


Author(s):  
A Alanezi ◽  
C Campbell ◽  
N Karp ◽  
A Andrade

Background: Epilepsy aphasia spectrum of disorders is characterized by developmental and language regression with EEG abnormalities that include electrical status epilepticus of sleep (ESES). Landau-Kleffner syndrome (LKS) and epileptic encephalopathy with continuous spike-wave during sleep (CSWS) are the most severe presentations. GRIN2A mutations have been recognized as causative. Methods: we present two sisters with different epilepsy phenotypes. A variant of unknown clinical significance (VUS) in GRIN2A gene was found in one of the sisters and her similarly affected father. Results: The first sister presented with focal onset seizures at the age of 3 years accompanied by language and cognitive regression and EEG features consistent of ESES, meeting criteria for LKS. Multiple anticonvulsants were tried until she responded well to steroids regaining developmental milestones. Her 5-year-old sister recently presented with focal onset seizures. Her language development is appropriate. Her EEG showed independent multifocal spikes but no ESES during sleep. Her seizures were controlled on monotherapy anticonvulsants. Conclusions: We observed a variable EEG-clinical phenotype and different severity among these family members as expected with GRIN2A-related disorders. This report contributes to evidence of the GRIN2A variant pathogenicity.


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