title: Therapy of encephalopathy with status epilepticus during sleep (ESES/CSWS syndrome): an update.
abstract: Electrical status epilepticus in sleep (ESES)/continuous spikes and waves during slow sleep (CSWS) is an age-related, self-limiting disorder characterised by epilepsy with different seizure types, global or selective neuropsychological regression, motor impairment, and a typical EEG pattern of continuous epileptiform activity for more than 85% of non-rapid eye movement (NREM) sleep. Although the first description of ESES/CSWS dates back to 1971, an agreement about the optimal treatment for this condition is still lacking. ESES/CSWS is rare (incidence is 0.2-0.5% of all childhood epilepsies) and no controlled clinical trials have been conducted to establish the efficacy of different antiepileptic drugs; only uncontrolled studies and case reports are reported in the literature. Treatment options for ESES/CSWS include some antiepileptic drugs (valproic acid, ethosuximide, levetiracetam, and benzodiazepines), steroids, immunoglobulins, the ketogenic diet, and surgery (multiple subpial transections). In this study, the comparative value of each of these treatments is reviewed and a personal therapeutic approach is proposed.
authors.affiliation: National Neurologic Institute "C. Mondino", Child Neuropsychiatry Unit, University of Pavia, Italy. pveggiot@unipv.it
authors.forename: Pierangelo
authors.initials: P
authors.lastname: Veggiotti
authors.forename: Maria Carmela
authors.initials: MC
authors.lastname: Pera
authors.forename: Federica
authors.initials: F
authors.lastname: Teutonico
authors.forename: Daniela
authors.initials: D
authors.lastname: Brazzo
authors.forename: Umberto
authors.initials: U
authors.lastname: Balottin
authors.forename: Carlo Alberto
authors.initials: CA
authors.lastname: Tassinari
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000601:surgery; D055423:Diet, Ketogenic; D004569:Electroencephalography; D004660:Encephalitis / Q000628:therapy*; D006801:Humans; D012893:Sleep Wake Disorders / Q000628:therapy*; D013226:Status Epilepticus / Q000628:therapy*
chemical_list: D000927:Anticonvulsants