Epilepsy with continuous spike-waves during slow wave sleep: a clinical and electroencephalographic study

Silva, Délrio F.; Lima, Márcia Marques; Gonzalez, Luzinete V.A.t.; Lopez, Odyna J. Lr.; Anghinah, Renato; Zanoteli, Edmar; lima, José Geraldo C.

doi:10.1590/S0004-282X1995000200011

Abstracts

We report four children with epilepsy with "continuous spike-waves during slow wave sleep" (CSWSS). The main clinical features were partial motor seizures, mental retardation and motor deficit. The EEG findings were characterized by nearly continuous (>85%) diffuse slow spike and wave activity in two patients, and localized to one hemisphere in two other cases during non-REM sleep. The treatment was effective in improving the clinical seizures, but not the EEG pattern. We believe that this epileptic syndrome has been overlooked and routine sleep EEG studies on epileptic children may disclose more cases of CSWSS.

epilepsy with continuous spike-waves during slow wave sleep; EEG; sleep

Relatamos quatro crianças epilépticas com "ponta-onda contínua durante o sono lento" (POCSL). Os principais achados clínicos foram crises parciais motoras,retardo mental e déficit motor. Os EEG se caracterizaram por complexos ponta-onda quase contínuos (>85%) difusos em dois pacientes e localizados em um hemisfério nos outros dois casos. O tratamento foi eficaz no controle das crises, mas não em relação ao EEG. Achamos que este quadro tem sido pouco relatado e estudos do sono em crianças epilépticas podem revelar mais casos de POCSL.

epilepsia com ponta-onda contínua do sono lento; EEG; sono

Epilepsy with continuous spike-waves during slow wave sleep: a clinical and electroencephalographic study

Epilepsia com ponta-onda contínua do sono lento: estudo clínico e eletrencefalográfico

Délrio F. Silva^I; Márcia Marques Lima^II; Luzinete V.A.t. Gonzalez^II; Odyna J. Lr. Lopez^II; Renato Anghinah^II; Edmar Zanoteli^III; José Geraldo C.lima^IV

^IHead of the EEG Sector, Escola Paulista de Medicina (EPM)

^IIJunior Doctor of the EEG Sector

^IIIPost Graduate Student

^IVFull Professor and Head of the Discipline of Neurology, EPM

SUMMARY

We report four children with epilepsy with "continuous spike-waves during slow wave sleep" (CSWSS). The main clinical features were partial motor seizures, mental retardation and motor deficit. The EEG findings were characterized by nearly continuous (>85%) diffuse slow spike and wave activity in two patients, and localized to one hemisphere in two other cases during non-REM sleep. The treatment was effective in improving the clinical seizures, but not the EEG pattern. We believe that this epileptic syndrome has been overlooked and routine sleep EEG studies on epileptic children may disclose more cases of CSWSS.

Key words:epilepsy with continuous spike-waves during slow wave sleep, EEG, sleep.

RESUMO

Relatamos quatro crianças epilépticas com "ponta-onda contínua durante o sono lento" (POCSL). Os principais achados clínicos foram crises parciais motoras,retardo mental e déficit motor. Os EEG se caracterizaram por complexos ponta-onda quase contínuos (>85%) difusos em dois pacientes e localizados em um hemisfério nos outros dois casos. O tratamento foi eficaz no controle das crises, mas não em relação ao EEG. Achamos que este quadro tem sido pouco relatado e estudos do sono em crianças epilépticas podem revelar mais casos de POCSL.

Palavras-chave: epilepsia com ponta-onda contínua do sono lento, EEG, sono.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 2-janeiro-1995.

Dr. Délrio F. Silva - Setor de Eletrencefalografia, Disciplina de Neurologia, Escola Paulista de Medicina - Rua Botucatu 740 - 04023-900 São Paulo SP - Brasil.

1. Beaumanoir A, Grandjean E. Continuous spike-and-wave discharges during sleep: significance. Electroenceph Clin Neurophysiol 1983, 55:18-19.
2. Billard C, Autrct A, Laffont F, De Giovanni E, Lucas B, Santini JJ, Dulac O, Plouin P. Aphasie acquise de l'enfant avec épilepsie: ŕ propos de 4 observations avec état de mal electrique infraclinique du sommeil. Rev EEG Neurophysiol 1981, 11:457-467.
3. Billard C, Autret A, Laffont F, Lucas B, De Giovanni E. Electrical status epilepticus during sleep in children: a reappraisal from eight new cases. In Sterman MB, Shouse P, Passouant P (eds). Sleep and epilepsy. San Diego: Academic Press, 1982, p 481-494.
4. Billard C, Autret A, Lucas A, De Giovanni E, Gillet P, Santini JJ, Toffol B. Are frequent spike-waves during non-REM sleep in relation with an acquired neuropsychological deficit in epileptic children? Neurophysiol Clin 1990, 20:439-454.
5. Chang W, Hunjan A. A closer look at the Landau-Kleffner syndrome and electrical status epilepticus during slow sleep: are they related? (Abstr) ASET/CAET Joint Scientific Program and Annual Meeting, 1990, p 21.
6. Colamaria V, Sgro V, Caraballo R, Simeone M, Zullini E, Fontana E, Zanetti R, Grimau-Merino R, Dalla-Bernardina B. Status epilepticus in benign rolandic epilepsy manifesting as anterior operculum syndrome. Epilepsia 1991, 32:329-334.
7. Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia 1989, 30:389-399.
8. Dalla Bemardina B, Tassinari CA, Dravet C, Bureau M, Beghini G, Roger J. Épilepsie partielle bénigne et état de mal électroencéphalographique pendant le sommeil. Rev EEG Neurophysiol 1978, 8:350-353.
9. Dalla Bernardina B, Fontana E, Michelizza B, Colamaria V, Capovilla G, Tassinari CA. Partial epilepsies of childhhod, bilateral synchronisation, continuous spike-wave during slow-sleep. In Manelis J, Bental E, Loeber JN, Dreifuss FE (eds). Advances in Epileptology, vol. 17. The XVIIth Epilepsy International Symposium. New York: Raven Press, 1989, p 295-302.
10. DeMarco P. Electrical status epilepticus during slow sleep: one case with sensory aphasia. Clin Electroenceph 1988, 19:111-113.
11. Fulgham JR, Groover RV, Klass DW. Subclinical electrographic status epilepticus during sleep (Abstr). American Electrographic Society Meeting, 1990, p A131.
12. Giovanardi-Rossi P, Calasso E, Ricciutello M. Deterioration des fonctions intellectuelles et du comportement chez des sujets avec décharges de pointe-ondes continues généralisées et bitemporales pendant le sommeil. Société Européenne de Neurologie Infantile, 9čme Reunion, Paris, 23-26 octobre 1986.
13. Jayakar PB, Seshia SS. Electrical status epilepticus during slow-wave sleep: a review. J Clin Neurophysiol 1991, 8:299-231.
14. Kellermann K. Recurrent aphasia with subclinical bioeletric status epilepticus during sleep. Eur J Ped 1978, 128:207-212.
15. Larrieu JL, Lagueny A, Ferrer X, Julien J. Épilepsie avec décharges continues au cours du sommeil lent: guerison sous clobazan. Rev EEG Neurophysiol Clin 1986, 16:383-394.
16. Laurette G, Arfel G. "État de mal" électrographique dans le sommeil d'aprečs-midi. Rev EEG Neurophysiol Clin 1976, 6:137-139.
17. Morikawa T, Seino M, Osawa R, Yagi K. Five children with continuous spike-wave discharges during sleep. In Roger J, Dravet C, Bureau M, Dreifuss FE, Wolf P (eds). Epileptic syndromes in infancy, childhood and adolescence. London: John Libbey Eurotext, 1985, p 205-212.
18. Morikawa T, Seino M, Watanabe Y, Watanabe M, Yagi K. Clinical relevance of continuous spike-wave during slow wave sleep. In Manelis J, Bental E, Loeber JN, Dreifuss FE (eds). Advances in Epileptology, vol. 17. The XVIIth Epilepsy International Symposium. New York: Raven Press, 1989, p 359-363.
19. Patry G, Lyagoubi S, Tassinari CA. Subclinical "electrical status epilepticus" induced by sleep in children: a clinical and electroencephalographic study of six cases. Arch Neurol 1971, 24:242-252.
20. Pelliccia A, Galletti F, Pierantoni R, Gulotta E, Ferrara, M, Brinciotti M, Benedetti P. Décharges EEG localisées continues pendant le sommeil chez l'enfant. Neurophysiol Clin 1989, 19:145-154.
21. Roulet E, Deonna T, Gaillard F, Peter-Faure C, Desplaud PA. Acquired aphasia, dementia, and behavior disorder with epilepsy and continuous spike and waves during sleep in a child. Epilepsia 1991, 32:495-503.
22. Tassinari CA, Bureau M, Dravet C, Roger J, Daniele-Natale O. Electrical status epilepticus during sleep in children (ESES). In Sterman MB, Shouse MM, Passouant P (eds). Sleep and epilepsy. San Diego: Academic Press, 1982:465-479.
23. Tassinari CA, Bureau M, Dravet C, Dalla Bernardina B, Roger J. Epilepsy with continuous spikes and waves during slow sleep. In Roger J, Dravet C, Bureau M, Dreifuss FE, Wolf O (eds). Epileptic syndromes in infancy, childhood and adolescence. London: John Libbey Eurotext, 1985, p 194-204.
24. Tiberge M, Calvet U, Soubiran C, Arbus L. Landau-Kleffner syndrome with continuous sharp waves during REM sleep (Abstr). Electroenceph Clin Neurophysiol 1988, 70:11.
25. Yasuhara A, Yoshida H, Hatanaka T, Sugimoto T, Kobayashi Y, Dyken E. Epilepsy with continuous spike-waves during slow sleep and its treatment. Epilepsia 1991, 32:59-62.

Publication Dates

Publication in this collection
20 Jan 2011
Date of issue
June 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Beaumanoir A, Grandjean E. Continuous spike-and-wave discharges during sleep: significance. Electroenceph Clin Neurophysiol 1983, 55:18-19.

[2] 2. Billard C, Autrct A, Laffont F, De Giovanni E, Lucas B, Santini JJ, Dulac O, Plouin P. Aphasie acquise de l'enfant avec épilepsie: ŕ propos de 4 observations avec état de mal electrique infraclinique du sommeil. Rev EEG Neurophysiol 1981, 11:457-467.

[3] 3. Billard C, Autret A, Laffont F, Lucas B, De Giovanni E. Electrical status epilepticus during sleep in children: a reappraisal from eight new cases. In Sterman MB, Shouse P, Passouant P (eds). Sleep and epilepsy. San Diego: Academic Press, 1982, p 481-494.

[4] 4. Billard C, Autret A, Lucas A, De Giovanni E, Gillet P, Santini JJ, Toffol B. Are frequent spike-waves during non-REM sleep in relation with an acquired neuropsychological deficit in epileptic children? Neurophysiol Clin 1990, 20:439-454.

[5] 5. Chang W, Hunjan A. A closer look at the Landau-Kleffner syndrome and electrical status epilepticus during slow sleep: are they related? (Abstr) ASET/CAET Joint Scientific Program and Annual Meeting, 1990, p 21.

[6] 6. Colamaria V, Sgro V, Caraballo R, Simeone M, Zullini E, Fontana E, Zanetti R, Grimau-Merino R, Dalla-Bernardina B. Status epilepticus in benign rolandic epilepsy manifesting as anterior operculum syndrome. Epilepsia 1991, 32:329-334.

[7] 7. Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia 1989, 30:389-399.

[8] 8. Dalla Bemardina B, Tassinari CA, Dravet C, Bureau M, Beghini G, Roger J. Épilepsie partielle bénigne et état de mal électroencéphalographique pendant le sommeil. Rev EEG Neurophysiol 1978, 8:350-353.

[9] 9. Dalla Bernardina B, Fontana E, Michelizza B, Colamaria V, Capovilla G, Tassinari CA. Partial epilepsies of childhhod, bilateral synchronisation, continuous spike-wave during slow-sleep. In Manelis J, Bental E, Loeber JN, Dreifuss FE (eds). Advances in Epileptology, vol. 17. The XVIIth Epilepsy International Symposium. New York: Raven Press, 1989, p 295-302.

[10] 10. DeMarco P. Electrical status epilepticus during slow sleep: one case with sensory aphasia. Clin Electroenceph 1988, 19:111-113.

[11] 11. Fulgham JR, Groover RV, Klass DW. Subclinical electrographic status epilepticus during sleep (Abstr). American Electrographic Society Meeting, 1990, p A131.

[12] 12. Giovanardi-Rossi P, Calasso E, Ricciutello M. Deterioration des fonctions intellectuelles et du comportement chez des sujets avec décharges de pointe-ondes continues généralisées et bitemporales pendant le sommeil. Société Européenne de Neurologie Infantile, 9čme Reunion, Paris, 23-26 octobre 1986.

[13] 13. Jayakar PB, Seshia SS. Electrical status epilepticus during slow-wave sleep: a review. J Clin Neurophysiol 1991, 8:299-231.

[14] 14. Kellermann K. Recurrent aphasia with subclinical bioeletric status epilepticus during sleep. Eur J Ped 1978, 128:207-212.

[15] 15. Larrieu JL, Lagueny A, Ferrer X, Julien J. Épilepsie avec décharges continues au cours du sommeil lent: guerison sous clobazan. Rev EEG Neurophysiol Clin 1986, 16:383-394.

[16] 16. Laurette G, Arfel G. "État de mal" électrographique dans le sommeil d'aprečs-midi. Rev EEG Neurophysiol Clin 1976, 6:137-139.

[17] 17. Morikawa T, Seino M, Osawa R, Yagi K. Five children with continuous spike-wave discharges during sleep. In Roger J, Dravet C, Bureau M, Dreifuss FE, Wolf P (eds). Epileptic syndromes in infancy, childhood and adolescence. London: John Libbey Eurotext, 1985, p 205-212.

[18] 18. Morikawa T, Seino M, Watanabe Y, Watanabe M, Yagi K. Clinical relevance of continuous spike-wave during slow wave sleep. In Manelis J, Bental E, Loeber JN, Dreifuss FE (eds). Advances in Epileptology, vol. 17. The XVIIth Epilepsy International Symposium. New York: Raven Press, 1989, p 359-363.

[19] 19. Patry G, Lyagoubi S, Tassinari CA. Subclinical "electrical status epilepticus" induced by sleep in children: a clinical and electroencephalographic study of six cases. Arch Neurol 1971, 24:242-252.

[20] 20. Pelliccia A, Galletti F, Pierantoni R, Gulotta E, Ferrara, M, Brinciotti M, Benedetti P. Décharges EEG localisées continues pendant le sommeil chez l'enfant. Neurophysiol Clin 1989, 19:145-154.

[21] 21. Roulet E, Deonna T, Gaillard F, Peter-Faure C, Desplaud PA. Acquired aphasia, dementia, and behavior disorder with epilepsy and continuous spike and waves during sleep in a child. Epilepsia 1991, 32:495-503.

[22] 22. Tassinari CA, Bureau M, Dravet C, Roger J, Daniele-Natale O. Electrical status epilepticus during sleep in children (ESES). In Sterman MB, Shouse MM, Passouant P (eds). Sleep and epilepsy. San Diego: Academic Press, 1982:465-479.

[23] 23. Tassinari CA, Bureau M, Dravet C, Dalla Bernardina B, Roger J. Epilepsy with continuous spikes and waves during slow sleep. In Roger J, Dravet C, Bureau M, Dreifuss FE, Wolf O (eds). Epileptic syndromes in infancy, childhood and adolescence. London: John Libbey Eurotext, 1985, p 194-204.

[24] 24. Tiberge M, Calvet U, Soubiran C, Arbus L. Landau-Kleffner syndrome with continuous sharp waves during REM sleep (Abstr). Electroenceph Clin Neurophysiol 1988, 70:11.

[25] 25. Yasuhara A, Yoshida H, Hatanaka T, Sugimoto T, Kobayashi Y, Dyken E. Epilepsy with continuous spike-waves during slow sleep and its treatment. Epilepsia 1991, 32:59-62.