Clinical spectrum and treatment outcome of 95 children with continuous spikes and waves during sleep (CSWS).

CSWS Continuous spikes and waves during sleep ESES Electrical status epilepticus during slow sleep Epilepsy Epileptic encephalopathy

Journal

European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society
ISSN: 1532-2130
Titre abrégé: Eur J Paediatr Neurol
Pays: England
ID NLM: 9715169

Informations de publication

Date de publication:
Jan 2021
Historique:
received: 06 06 2020
revised: 22 08 2020
accepted: 24 10 2020
pubmed: 3 11 2020
medline: 9 6 2021
entrez: 2 11 2020
Statut: ppublish

Résumé

Continuous spikes and waves during sleep (CSWS) is an epileptic encephalopathy characterized by generalised epileptiform activity and neurocognitive dysfunction. Causes and outcome are diverse and treatment is mainly empirical. Retrospective descriptive analysis of clinical and EEG data of children with CSWS diagnosed between 1998 and 2018 at the University Hospital Heidelberg. Ninety-five children were included with a median age at diagnosis of 5.4 years. A structural/metabolic aetiology was found in 43.2%, genetic alterations in 17.9%, while it remained unknown in 38.9%. The proportion of patients with genetic aetiology increased from 10.3% (1998-2007) to 22.8% (2008-2018). On average, each patient received 5 different treatments. CSWS was refractory in >70% of cases, steroids and neurosurgery were most effective. No difference was observed between children with CSWS or Near-CSWS (Spike-Wave-Index 40-85%). Our cohort confirms CSWS as an age-dependent epileptic encephalopathy. Structural brain abnormalities were most frequent, but genetic causes are increasingly identified. More specific criteria for the diagnosis and treatment goals should be elaborated and implemented based on evidence. This study is the largest monocentric observational study on treatment effects in children with CSWS, providing data for diagnostic and therapeutic decisions.

Identifiants

pubmed: 33132036
pii: S1090-3798(20)30203-8
doi: 10.1016/j.ejpn.2020.10.010
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

121-127

Informations de copyright

Copyright © 2020 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Auteurs

Benedikt Sonnek (B)

Division of Paediatric Epileptology, Centre for Paediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany.

Jan Henje Döring (JH)

Division of Paediatric Epileptology, Centre for Paediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany.

Ulrike Mütze (U)

Division of Paediatric Neurology and Metabolic Medicine, Centre for Paediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany.

Susanne Schubert-Bast (S)

Centre for Paediatric Medicine, Neuropaediatric and Centre for Epilepsy Frankfurt Rhein-Main, Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.

Thomas Bast (T)

Clinic for Children and Adolescents, Epilepsy Centre Kork, Landstraße 1, 77694 Kehl-Kork, Germany.

Doreen Balke (D)

Division of Paediatric Epileptology, Centre for Paediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany.

Gitta Reuner (G)

Division of Paediatric Neurology and Metabolic Medicine, Centre for Paediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany; Institue of Education Studies, Faculty of Behavioural and Cultural Studies, Heidelberg University, Akademiestr. 3, 69117 Heidelberg, Germany.

Elisabeth Schuler (E)

Division of Paediatric Neurology and Metabolic Medicine, Centre for Paediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany.

Annick Klabunde-Cherwon (A)

Division of Paediatric Epileptology, Centre for Paediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany.

Georg F Hoffmann (GF)

Division of Paediatric Epileptology, Centre for Paediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany; Division of Paediatric Neurology and Metabolic Medicine, Centre for Paediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany.

Stefan Kölker (S)

Division of Paediatric Neurology and Metabolic Medicine, Centre for Paediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany.

Steffen Syrbe (S)

Division of Paediatric Epileptology, Centre for Paediatrics and Adolescent Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany. Electronic address: steffen.syrbe@med.uni-heidelberg.de.

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Classifications MeSH