Abstracts

Rationale: Rationale: The goal of this study was to determine if there were certain predictive factors in the long-term video EEG (LTM) of patients with electrical status epilepticus of sleep (ESES) that could help predict patient response to treatment. Methods: We reviewed the LTM of 26 patients that had EEG reports classified as having ESES between the years of 2005-2011 at Nationwide Children's Hospital. We reviewed whether polyspikes were present, and calculated spike wave indexes (SWI %) and categorized them based on published criteria. In addition, we determined whether the discharges were focal or generalized and if focal, in which location. We also documented if the patient had discharges present while the patient was awake. If treatment was offered, we noted their therapeutic response to the given treatment. Results: 12 of 26 patients were essentially treated with either the high-dose valium protocol or steroids. Of the 12 treated patients, 4 patients responded well to treatment and 8 patients were refractory to treatment. Of the 8 patients that were refractory to treatment, 6 patients had polyspikes present on their LTM (one sided p-value=.0303). Of the 4 patients that responded well to treatment, zero had polyspikes. In terms of SWI category, 5/8 of the refractory patients had a higher category(level 2 or 3), and only 3/8 of the refractory patients were category 1 (SWI%<50%). Finally, of the 4 patients that responded to medication treatment, zero were category 1 and 4/4 were either category 2 or 3. Conclusions: This study supports the hypothesis that the presence of polyspikes is a statistically significant predictor of being refractory to medication. It also supports the trend that lower percentages of SWI could be predictive of possibly being refractory to treatment and suggests the need for a larger patient population for further studies.