Abstracts

The EEG pattern of CSWS (continuous spike waves during slow sleep) may influence language or cognitive functions. Recently, we have seen many children with a CSWS-like EEG pattern. The aim of this study was to assess school performance and behavior in such children treated with levetiracetam (LEV)., We performed a prospective open label intervention study in 50 children (age: 5-12 yr) in whom 24-h EEG showed a vast increase of epileptiform activity during slow wave sleep. We employed a new method for assessment of nocturnal epileptiform discharges developed at our epilepsy centre. The children had spike-indexes of 30-90% of slow wave sleep. 25-35 % of them was either seizure free or had never experienced epileptic seizures. Language/dyslectic problems, ADHD or concentration- and behavioral problems appeared to be the most common clinical disabilities. Moreover, some patients had symptoms within the autism spectrum disorders (ASD). LEV treatment was given (usually as add on) in doses 20-25mg/kg/day, after 4-8 weeks of titration. 24-hour EEG was performed after 3-7 months of treatment. A reduction in epileptiform activity was assessed as either reduction in percentage time of spiking or as bifocal epileptiform activity becoming monofocal. Parents were asked about changes in the children[apos]s behavior, cognitive functions or school performance., LEV caused a reduction in epileptiform activity in 24-h EEG in 65% of the patients. 24-h EEG became normal within 6 months in 25% of the cases. Parents reported positive clinical effects in more than half of those cases with an improved or normalized EEG., Children may benefit from treatment of sleep-related epileptiform activity in EEG, also when such activity are less prominent than in classical CSWS. Perhaps CSWS is only the [ldquo]tip of the iceberg[rdquo]? We believe that our observations call for further studies within this exciting field., (Supported by National centre for epilepsy, Norway.)