Abstracts

Rationale: Epilepsy with continuous spikes and waves during slow-wave sleep (CSWS) is an age-related encephalopathy characterized by heterogeneous clinical manifestations and a specific electroencephalographic (EEG) pattern of CSWS. The optimal length of treatment for Epilepsy with CSWS is unclear. The aim of this study was to examine the status of termination of treatment for epilepsy with CSWS. Methods: By reviewing the medical records, we identified 89 patients with epilepsy with CSWS who were treated and followed for at least six months at our hospital. The patients comprised 42 males and 47 females with ages ranging from 5 to 42 years (average, 15 years) at the last follow-up. Their clinical data were analyzed based on medical reports and EEG records. Results: Among 89 patients, 76 patients (85.4%) were completely seizure-free. 45 patients attempted to discontinue antiepileptic drugs (AEDs) at ages 6 to 22 years. 24 patients including 2 with MRI abnormality successfully discontinued AEDs at ages 9 to 25 years, and the periods between the last seizure and start of AEDs withdrawal ranged from 0 to 15 years (average 5.2 years). 27 patients started tapering AEDs before EEG was normalized. 9 patients could uneventfully discontinue AEDs, however during tapering of or after discontinuing AEDs seizures relapsed in 7 patients and EEG findings worsened in 2 patients. 3 patients with relapsed seizures and 1 patient with exacerbated EEG abnormality tried again and finally discontinued AEDs with normalization of EEG. In 18 patients of whom EEG was normalized before starting to taper AEDs, 11 patients could successfully discontinue AEDs. Conclusions: This retrospective study shows that patients with epilepsy with CSWS can discontinue AEDs. A prospective study is warranted to examine AEDs withdrawal in these patients when seizures have been controlled. Normalization of EEG finding may increase the chance of successful AED withdrawal. Funding: The authors received no specific funding for this work.