EPILEPTIC ENCEPHALOPATHIES WITH ELECTRICAL STATUS EPILEPTICUS OF SLOW-WAVE SLEEP (ESES): DIAGNOSIS AND PHARMACOTHERAPY

EPILEPTIC ENCEPHALOPATHIES WITH ELECTRICAL STATUS EPILEPTICUS OF SLOW-WAVE SLEEP (ESES): DIAGNOSIS AND PHARMACOTHERAPY

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Electrical status epilepticus of slow sleep (ESES) is a sleep EEG pattern with a continuous (85-100%) diffuse epileptiform activity.The morphology of these epileptiform complexes is identical to benign epileptiform discharges of childhood (BEDC).Epilepsy with ESES (or Penelope Syndrome) is a form of age-dependent epileptic encephalopathies with continuous spike-wave activity during slow wave sleep.

This group of epilepsies also includes Pseudo-Lennox syndrome, Landau-Kleffner syndrome, autistic epileptiform regression and some others.Usually, the ESES pattern correlates Collections with the severity of cognitive deficit in epileptic children.The list of anti-epileptic drugs (AEDs) used in pharmacotherapy of epileptic encephalopathies includes valproates, levetiracetam, ethosuximide, sulthiame, topiramate, zonisamide and benzodiazepines; those are given in monotherapy or rationalized combined therapy.

Levetiracetam was highly effective in 67.6% of patients with ESES (n=23); among them, two cases of clinical and EEG remission during the pre-puberty period, nine cases of clinical remission and 12 cases with a significant decrease in seizures and epileptiform discharges.In 20.

6% of patients (n=7), the Automotive pharmacotherapy showed low efficacy.In 11.8% of patients (n=4), aggravation of the disease was noted.

Combinations of levetiracetam with valproates and levetiracetam with ethosuximide were found the most effective AEDs.In the cases of epileptogenic structural defect that underlines drug-resistant epilepsy with ESES, neurosurgical intervention is recommended.