Abstracts

Rationale: “Electrical Status Epilepticus during Sleep”, (ESES) is characterized with continuous spike and waves during slow wave sleep (CSWS). This is an age dependent abnormality seen before adolescence and associated with different degrees of cognitive and behavioral problems. Early intervention and treatment of ESES is very important to prevent permanent neuropsychological impairment.Methods: 8 children (4 girls and 4 boys) aged between 7-12 years old diagnosed with ESES were analysed retrospectively based on their clinical and EEG findings. The children received oral clonazepam treatment at bedtime in addition to their current antiepileptic medications. Add-on clonazepam continued for at least 3 months to 15 months. During the follow-up, for each patient had 2 to 4 EEG recordings with minimum one hour-sleep component besides awake periods.Results: We compared EEG recordings in 8 patients before and after CLN treatment. Of those 8 patients, 4 of them had hemispheric ESES pattern on their EEGs. Two patients with hemispheric and 2 patients with generalized ESES pattern were normalized after clonazepam treatment. One of the two patients with hemispheric ESES pattern did reveal focal epileptic abnormality at the time of the one-year follow-up visit. In the remaning 4 patients, one had reduced discharges at 3-month follow-up but she did not return for follow-up again. Three of all patients did not show any improvement with clonazepam. Clonazepam was stopped in one case who suffered side effects besides (somnolance) ineffectiveness at the time of his 3-month follow-up visit. Of two patients, dose were re-adjusted because of some side effects such as lowered eye lids, enurezis nocturna, vertigo and double vision.Conclusions: Oral add on clonazepam treatment could be beneficial in treating children with ESES pattern. Bedtime dosing of clonazepam seemed to have less side effects while it helps supressing the epileptic discharges during sleep.