title: Characteristics and Management of Children with Continuous Spikes and Waves during Slow Sleep.
abstract: This study was done to describe the clinical spectrum, EEG characteristics and treatment modalities in children with continuous spike and slow wave in sleep (CSWS). Ten patients with CSWS had been treated between 2012 and 2013. Mean age of the patients was 6.9 years; male female ratio was 3:2. The main etiologic group in this study was epilepsy (10), cerebral palsy (3) and brain lesion (arachnoid cyst). All the patients had prior seizure. Presenting features were abnormal behavior (4), agitation (4), aggression (4), eye blinking (2) and involuntary movement (2). Three patients had speech regression and 1 had motor regression. Regarding EEG finding, 7 out 10 cases had SWI>85% whereas, rest of them had SWI 50 to 80%. Most of the patients were resistant to two or more oral AED. The AED found to be efficacious were Midazolam drip, pulse methyl prednisolone and valproate. Eighty percent (80%) patient responded to midazolam drip. Methyl prednisolone caused 50% improvement in one patient but failed in 2 cases. In contrast to the previous studies where high dose valproic acid, levetiracetam, Injection ACTH was more efficacious, this study demonstrates significant positive result with midazolam drip.
authors.affiliation: Dr Kanij Fatema, Assistant Professor, Pediatric Neurology Unit, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
authors.forename: K
authors.initials: K
authors.lastname: Fatema
authors.forename: M M
authors.initials: MM
authors.lastname: Rahman
authors.forename: S
authors.initials: S
authors.lastname: Begum
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D012890:Sleep / Q000502:physiology*
chemical_list: D000927:Anticonvulsants