title: Long-term response to high-dose diazepam treatment in continuous spikes and waves during sleep.
abstract: BACKGROUND
  This study evaluated whether the reduction in epileptiform activity after treatment with high-dose diazepam in continuous spikes and waves during sleep persists over time.
  
  
  METHODS
  Patients aged 1 to 21 years with continuous spikes and waves during sleep who received high-dose nocturnal diazepam and who had electroencephalogram follow-up were included. Twenty-nine patients met the inclusion criteria and underwent a total of 48 high-dose diazepam treatment cycles.
  
  
  RESULTS
  An overnight reduction of the spike wave percentage of at least 25% (i.e., 75-50%) occurred in 29 cycles (20 patients), and persisted within 6 months in 16 of 29 cycles (12 patients), but returned to baseline in three of 29 cycles (three patients). An overnight reduction of at least 50% (i.e., 75-25%) occurred in 15 cycles (13 patients), and persisted within 6 months in eight of 15 cycles (eight patients), but returned to baseline in three cycles (three patients). Twenty of 29 cycles that responded in the short term had persistent response on follow-up. Thirteen cycles of treatment were associated with mild side effects that did not recur with repeated treatment cycles.
  
  
  CONCLUSIONS
  Treatment with high-dose diazepam reduced epileptiform activity in continuous spikes and waves during sleep in the short term, and improvement persisted for several months in most cycles. Short-term response predicted persistence of this effect on subsequent follow-up.
authors: Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors: Iván
authors: I
authors: Sánchez Fernández
authors: Jurriaan M
authors: JM
authors: Peters
authors: Sookee
authors: S
authors: An
authors: Ann Marie
authors: AM
authors: Bergin
authors: Masanori
authors: M
authors: Takeoka
authors: Alexander
authors: A
authors: Rotenberg
authors: Sanjeev V
authors: SV
authors: Kothare
authors: James Jim
authors: JJ
authors: Riviello
authors: Tobias
authors: T
authors: 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; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies; D012890:Sleep / Q000187:drug effects*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D003975:Diazepam
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