Abstracts

Rationale: Status Epilepticus during Slow-Wave Sleep is an encephalopathy that may leave permanent sequelae in children. To achieve good neuropsychological results timely treatment and strict follow up are essential. We describe the clinical and electroencephalographic characteristics and response to treatment of Chilean patients with ESES. Methods: Retrospective recollection of demographical, clinical EEG, neuropsychological and follow up data from patients with diagnosis of ESES controlled between 2008-2016 at Pontificia Universidad Católica de Chile. Results: We included 24 patients, 13 females. Actual average age is 11yo (range 2-21). Five patients had prior history of developmental delay. Average ages at onset of ESES was 6yo and 14 had Benign Epilepsy with Central-Temporal Spikes (BECTS), one of them with atypical features. Two patients didn't have clinical seizures. The average age of initiation of cognitive decline and diagnosis of ESES was 6yo. MRI was normal in 16. All patients were treated. The average delay between symptoms debut and initiation of treatment was 9 months. Three patients responded to first line treatment (antiepileptic drugs)(AEDs), 9 responded to second line (AEDs with benzodiazepines), 11 needed steroids and one immunoglobulins. ESES electroencephalographic response was positive in 18, 5 persisted with the EEG pattern and 1 relapsed. At follow up, 8 patients have normal cognitive performance. ESES duration before treatment was associated with persistent cognitive impairment Conclusions: Children with epilepsy that develop cognitive impairment, should be screened for ESES, especially in patients with BECTS. There are no treatment guidelines, but stepwise use of AEDs, benzodiazepines and immunotherapy (steroids) was useful in our group. In future studies, we need to develop follow up protocols (EEG, treatment, neuropsychological) to optimize the treatment, control this encephalopathy and improve the outcome. Funding: No funding was received.