Dados do Trabalho

Título

CSWS in a tertiary electroencephalography center

Introdução

The Continuous Spikes and Waves during Sleep (CSWS) is an electroencephalographic pattern common to several epileptic syndromes. CSWS is characterized by spike-wave complexes activated during non–rapid eye movement (REM) sleep in children and fulfilling a spike-wave index of greater than 85%, as previously defined in 1971 by Patry et al, or at least 50% of the sleep as proposed in guidelines formulated by Scheltens-de Boer in 2009.

Objetivo

To compare the reason for requesting the exam, the presence of structural damage and the treatment prescribed in 12 patients diagnosed with CSWS from the Department of Clinical Neurophysiology of the Hospital de Base de São José do Rio Preto, between 2015 and 2022, by Video-Encephalographic Monitoring (VEEG). We compared whether data found in our patients correspond to the literature on the subject.

Método

A review of medical records and VEEG data was made from patients in this study. A total of 1823 patients were evaluated and 12 were included in the present study due to the presence of CSWS.

Resultados

Among the 12 patients, 6 were males and 6 females, which shows the lack of gender preference reported in the literature. All were followed by a child neurologist due to epilepsy and the reason for requesting the exam was monitoring such pathology. The age of the first exam with CSWS ranged in our service from 3 to 11 years. 5 of them had normal neuroimaging, while 7 had some type of structural brain lesion, with leukomalacia being found in 3 cases, 2 cases of dysplasia and 1 of polymicrogyria. The literature shows a prevalence of structural injury around 40% associated with CSWS. In 10 patients, the treatment prescribed involved a type of benzodiazepine, which is usually one of the recommend antiepileptic drug by the literature. In addition, one patient underwent pulse therapy with methylprednisolone, showing good clinical and electroencephalographic response, which is also found as a therapeutic possibility by other authors.

Conclusão

our service data, a reference service of São Paulo, coincide with the medical literature about the presence of structural brain injury, treatments used, epidemiology and prevalence of seizures among patients with CSWS. The variability of available clinical treatments and their profound impact on neurodevelopment and knowledge point out the importance of recognizing this EEG pattern and its proper treatment, as well as the correlation between clinical and neurophysiological features.

Palavras-chave

CSWS; EEG; REM-sleep