title: Short-term response of sleep-potentiated spiking to high-dose diazepam in electric status epilepticus during sleep.
abstract: We describe the short-term effects of high-dose oral diazepam on sleep-potentiated epileptiform activity in patients with electric status epilepticus during sleep. We enrolled patients treated with high-dose oral bedtime diazepam from 2001-2009. We defined spike percentage as the percentage of 1-second bins containing at least one spike, and calculated it during three randomly selected 5-minute samples of wakefulness throughout the day and during the first 5 minutes of every hour of non-rapid eye movement sleep at night. In this study, patients were considered to demonstrate sleep-potentiated epileptiform activity when their spike percentage during sleep was increased by ≥50% compared with wakefulness. Twenty-nine children (18 boys) were included (median age, 7.4 years). Twenty-four hours after receiving high-dose diazepam, epileptiform activity was significantly reduced (76.7% at baseline vs 40.8% 24 hours after high-dose diazepam; Wilcoxon signed ranks test, Z = -4.287, P < 0.0001). Seven patients (24.1%) manifested mild, reversible side effects during the first 48 hours after diazepam administration. High-dose oral diazepam effectively and safely reduced epileptiform activity in patients with electric status epilepticus during sleep.
authors.affiliation: Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts 02115, USA.
authors.forename: Iván
authors.initials: I
authors.lastname: Sánchez Fernández
authors.forename: Stavros
authors.initials: S
authors.lastname: Hadjiloizou
authors.forename: Yaman
authors.initials: Y
authors.lastname: Eksioglu
authors.forename: Jurriaan M
authors.initials: JM
authors.lastname: Peters
authors.forename: Masanori
authors.initials: M
authors.lastname: Takeoka
authors.forename: Emir
authors.initials: E
authors.lastname: Tas
authors.forename: Imane
authors.initials: I
authors.lastname: Abdelmoumen
authors.forename: Alexander
authors.initials: A
authors.lastname: Rotenberg
authors.forename: Sanjeev V
authors.initials: SV
authors.lastname: Kothare
authors.forename: James J
authors.initials: JJ
authors.lastname: Riviello
authors.forename: Tobias
authors.initials: T
authors.lastname: Loddenkemper
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D058256:Brain Waves / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D003975:Diazepam / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012890:Sleep / Q000187:drug effects* / Q000502:physiology; D018709:Statistics, Nonparametric; D013226:Status Epilepticus / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors; D014851:Wakefulness / Q000187:drug effects
chemical_list: D000927:Anticonvulsants; D003975:Diazepam