Abstracts

Rationale: The term Encephalopathy associated with ESES is used to identify the syndrome of continuous spike and wave of slow wave sleep (CSWS) as well as Landau-Kleffner syndrome (LKS). Different treatment modalities are associated with variable success. High dose diazepam challenge test is used by some centers to identify suitable patients for nocturnal high dose diazepam maintenance therapy. Objective: To calculate the effect of high dose diazepam in the sleep EEG of children with ESES Methods: Inclusion criteria: 1. Children aged 3-12 years diagnosed with ESES during January 2008- December 2010 2. ESES defined as spike-wave index (SWI) of >85% during sleep or >50% if the awake EEG showed a SWI of <20%. 3. Behavioual and or cognitive challenges reported by the caregiver/healthcare professional Exclusion criteria: 1. Known myoclonic epilepsy syndrome (Eg: Lennox-Gestaut syndrome) 2. On Carbamazepine/oxcarbazepine in the preceding 2 months. Epilepsy and EEG database of McMaster Children s Hospital were used to identify the patients. Patients were prospectively followed in the neurology clinic from the time of diagnosis. 1mg/kg of Diazepam (maximum 40 mg) was given in 2 equal half doses 2 hours apart in the late evening orally or rectally. Sleep SWI was calculated two hours after the second dose of diazepam. Good response was defined as decrease in sleep SWI by >