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[Electroencephalography in status epilepticus in sleep (ESES) in various clinical pictures].
Acta Med Croatica. 2005; 59(1):69-74.AM

Abstract

Electroencephalographic epileptic status during sleep (ESES--according to Electrical Status Epilepticus in Sleep) is characterized with paroxysmal attacks of 1.5-3.5 (even to 5) Hz/s spikes and waves during NREM. A case is presented of a 7-year-old boy who had normal development until 3 years of age when epileptic attacks started. First to appear were left-sided, hemifacial twitches with orofacio-lingual deficits. Despite treatment with various types and combinations of antiepileptic medications, the attacks persisted and became more frequent. About a year after the onset of the disease, the spectrum of epileptic attacks had expanded (left-sided tonic-clonic, atonic-astatic, myoclonic, atypical absences, and then drop attacks and negative myoclonic seizures became dominant). The boy appeared mentally retarded. During the course of the disease, the diagnoses varied: hemifacial twitches, partial epilepsy, left-sided partial epilepsy, atypical benign epilepsy, Landau-Kleffner syndrome, myoclonic-astatic epilepsy. A year and a half after the onset of the disease EEG (polysomnographic whole-night recording) revealed electrical status epilepticus in sleep (ESES) with spike-wave index > 85%. It appeared that this was continuous spike and wave during slow wave sleep syndrome (CSWS) with characteristic attacks, bifrontal atrophies on brain CT and right frontotemporal EEG focus. Treatment with valproate and ethosuximide combined with vigabatrin and clonazepam seemed to be effective. In the last 20 months ESES is rare and transitory, mental and neuropsychological functions have improved, but he still has several hemifacial twitches daily. The two brain MRI scans were normal. Differential diagnosis can be atypical benign epilepsy (suspected familial diagnosis). Family history of atopy, 'persistent' colds and obstructive bronchitis in the boy and treatment with antiepileptic medications (especially carbamazepine, phenobarbital and phenytoin) could have been provoking or modulating factors of the epileptic disease. So far we have not identified an epileptic syndrome because it seems that multiple clinical pictures overlap. ESES could be diagnosed using polysomnographic whole-night recording with calculated spike-wave index. Follow-up of the spike-wave index could be useful in differentiation, but not in precise diagnosis of epileptic syndrome. Clinical course could be modulated by different factors. Continuous following over a long period could be helpful in the classification of epilepsy.

Authors+Show Affiliations

Specijalna bolnica za zastitu djece s neurorazvojnim i motorickim smetnjama, Zagreb, Hrvatska.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

hrv

PubMed ID

15813359

Citation

Popović Miocinović, Ljiljana, et al. "[Electroencephalography in Status Epilepticus in Sleep (ESES) in Various Clinical Pictures]." Acta Medica Croatica : Casopis Hravatske Akademije Medicinskih Znanosti, vol. 59, no. 1, 2005, pp. 69-74.
Popović Miocinović L, Durrigl V, Kapitanović Vidak H, et al. [Electroencephalography in status epilepticus in sleep (ESES) in various clinical pictures]. Acta Med Croatica. 2005;59(1):69-74.
Popović Miocinović, L., Durrigl, V., Kapitanović Vidak, H., Grubesić, Z., & Sremić, S. (2005). [Electroencephalography in status epilepticus in sleep (ESES) in various clinical pictures]. Acta Medica Croatica : Casopis Hravatske Akademije Medicinskih Znanosti, 59(1), 69-74.
Popović Miocinović L, et al. [Electroencephalography in Status Epilepticus in Sleep (ESES) in Various Clinical Pictures]. Acta Med Croatica. 2005;59(1):69-74. PubMed PMID: 15813359.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Electroencephalography in status epilepticus in sleep (ESES) in various clinical pictures]. AU - Popović Miocinović,Ljiljana, AU - Durrigl,Vera, AU - Kapitanović Vidak,Helena, AU - Grubesić,Zdravko, AU - Sremić,Stefica, PY - 2005/4/9/pubmed PY - 2005/5/4/medline PY - 2005/4/9/entrez SP - 69 EP - 74 JF - Acta medica Croatica : casopis Hravatske akademije medicinskih znanosti JO - Acta Med Croatica VL - 59 IS - 1 N2 - Electroencephalographic epileptic status during sleep (ESES--according to Electrical Status Epilepticus in Sleep) is characterized with paroxysmal attacks of 1.5-3.5 (even to 5) Hz/s spikes and waves during NREM. A case is presented of a 7-year-old boy who had normal development until 3 years of age when epileptic attacks started. First to appear were left-sided, hemifacial twitches with orofacio-lingual deficits. Despite treatment with various types and combinations of antiepileptic medications, the attacks persisted and became more frequent. About a year after the onset of the disease, the spectrum of epileptic attacks had expanded (left-sided tonic-clonic, atonic-astatic, myoclonic, atypical absences, and then drop attacks and negative myoclonic seizures became dominant). The boy appeared mentally retarded. During the course of the disease, the diagnoses varied: hemifacial twitches, partial epilepsy, left-sided partial epilepsy, atypical benign epilepsy, Landau-Kleffner syndrome, myoclonic-astatic epilepsy. A year and a half after the onset of the disease EEG (polysomnographic whole-night recording) revealed electrical status epilepticus in sleep (ESES) with spike-wave index > 85%. It appeared that this was continuous spike and wave during slow wave sleep syndrome (CSWS) with characteristic attacks, bifrontal atrophies on brain CT and right frontotemporal EEG focus. Treatment with valproate and ethosuximide combined with vigabatrin and clonazepam seemed to be effective. In the last 20 months ESES is rare and transitory, mental and neuropsychological functions have improved, but he still has several hemifacial twitches daily. The two brain MRI scans were normal. Differential diagnosis can be atypical benign epilepsy (suspected familial diagnosis). Family history of atopy, 'persistent' colds and obstructive bronchitis in the boy and treatment with antiepileptic medications (especially carbamazepine, phenobarbital and phenytoin) could have been provoking or modulating factors of the epileptic disease. So far we have not identified an epileptic syndrome because it seems that multiple clinical pictures overlap. ESES could be diagnosed using polysomnographic whole-night recording with calculated spike-wave index. Follow-up of the spike-wave index could be useful in differentiation, but not in precise diagnosis of epileptic syndrome. Clinical course could be modulated by different factors. Continuous following over a long period could be helpful in the classification of epilepsy. SN - 1330-0164 UR - https://www.unboundmedicine.com/medline/citation/15813359/[Electroencephalography_in_status_epilepticus_in_sleep__ESES__in_various_clinical_pictures]_ L2 - http://www.diseaseinfosearch.org/result/6864 DB - PRIME DP - Unbound Medicine ER -