Continuous spike and wave in slow-wave sleep (CSWS) is an electroencephalographic (EEG) pattern characterized by generalized spike-wave discharges occurring for at least 85% of non–rapid eye movement (non-REM) sleep, with marked attenuation during rapid eye movement (REM) sleep. It has been described in a large number of structural and nonstructural neurologic conditions and is associated with epilepsy, behavioral disturbances, and severe neuropsychiatric impairment. We describe continuous spike and wave in slow-wave sleep in 2 patients (one with Rett syndrome and the other with Lhermitte-Duclos syndrome). To our knowledge, continuous spike and wave in slow-wave sleep has not been previously described in these conditions.
GuerriniRGentonPBureauM. Multilobar polymicrogyria, intractable drop attack seizures, and sleep-related electrical status epilepticus. Neurology. 1998;51:504–512.
2.
GuzzettaFBattagliaDVerediceC. Early thalamic injury associated with epilepsy and continuous spike-wave during slow sleep. Epilepsia. 2005;46:889–900.
3.
VeggiottiPBeccariaFPapaliaG. Continuous spikes and waves during sleep in children with shunted hydrocephalus. Childs Nerv Syst. 1998;14:188–194.
4.
Van BogaertP. Epileptic encephalopathy with continuous spike-waves during slow-wave sleep including Landau-Kleffner syndrome. Handb Clin Neurol. 2013;111:635–640.
5.
NeimanESSeyffertMRichardsAGuptaDChokrovertyS. Epilepsy with continuous spikes and waves during slow wave sleep in a child diagnosed with pervasive developmental disorder-not otherwise specified. Sleep Med. 2010;11:799–802.
6.
ValvoGNovaraFBrovedaniP. 22q11.2 Microduplication syndrome and epilepsy with continuous spikes and waves during sleep (CSWS). A case report and review of the literature. Epilepsy Behav. 2012;25:567–572.
7.
PaltryGLyagoubiSTassinariCA. Subclinical electrical status epilepticus induced by sleep in children. A clinical and electroencephalographic study of six cases. Arch Neurol. 1971;24:242–252.
8.
TassinariCADravetCRogerJ. Encephalopathy related to electrical status epilepticus during slow sleep. Elect Clin Neurophysiol. 1977;43:529–530.
9.
MalowBAPlazziG. Nocturnal Seizures. In: ChokrovertySHeningWAWaltersAS, eds. Sleep and Movement Disorders. Philadelphia, PA: Butterworth-Heinemann; 2003:395–408.
StrianoPCapovillaG. Epileptic encephalopathy with continuous spikes and waves during sleep. Curr Neurol Neurosci Rep. 2013;3:360.
12.
CaraballoRHVeggiottiPKaltenmeierMC. Encephalopathy with status epilepticus during sleep or continuous spikes and waves during slow sleep syndrome: a multicenter, long-term follow-up study of 117 patients. Epilepsy Res. 2013;105:164–173.
13.
CaraballoRFontanaEMichilezzaB. CBZ inducing atypical absences, drop-spells and continuous spike and waves during slow sleep (CSWS). Boll Lega It Epil1989;66/67:379–381.
14.
InutsukaMKobayashiKOkaMHattoriJOhtsukaY. Treatment of epilepsy with electrical status epilepticus during slow sleep and its related disorders. Brain Dev. 2006;28:281–286.
15.
FejermanNCaraballoRCersósimoRFerraroSMGalicchioSAmartinoH. Sulthiame add-on therapy in children with focal epilepsies associated with encephalopathy related to electrical status epilepticus during slow sleep (ESES). Epilepsia. 2012;53:1156–1161.
16.
AtkinsMNikanorovaM. A prospective study of levetiracetam efficacy in epileptic syndromes with continuous spikes-waves during slow sleep. Seizure. 2011;20:635–639.
17.
AebyAPoznanskiNVerheulpenDWetzburgerCVan BogaertP. Levetiracetam efficacy in epileptic syndromes with continuous spikes and waves during slow sleep: experience in 12 cases. Epilepsia. 2005;46:1937–1942.
18.
AdachiMOyazatoYNishiyamaAMuraseMIshidaA. Efficacy of topiramate in childhood epilepsies [in Japanese]. No To Hattatsu. 2010;42:360–366.
19.
BuzatuMBulteauCAltuzarraC. Corticosteroids as treatment of epileptic syndromes with continuous spike-waves during slow-wave sleep. Epilepsia. 2009;50(suppl 7):68–72.
20.
ArtsWFAarsenFKScheltens-de BoerM. Landau-Kleffner syndrome and CSWS syndrome: treatment with intravenous immunoglobulins. Epilepsia. 2009;50(suppl 7):55–58.
21.
NikanorovaMMirandaMJAtkinsMSahlholdtL. Ketogenic diet in the treatment of refractory continuous spikes and waves during slow sleep. Epilepsia. 2009;50:1127–1131.
22.
VeggiottiPPeraMCTeutonicoFBrazzoDBalottinUTassinariCA. Therapy of encephalopathy with status epilepticus during sleep (ESES/CSWS syndrome): an update. Epileptic Disord. 2012;14:1–11.
23.
SegawaMNomuraY. Polysomnography in the Rett syndrome. Brain Dev. 1992;14(suppl):S46–S54.
24.
GlazeDGFrostJDJrZoghbiHYPercyAK. Rett's syndrome: characterization of respiratory patterns and sleep. Ann Neurol. 1987;21:377–382.
25.
GlazeDGFrostJDJrZoghbiHYPercyAK. Rett's syndrome: correlation of electroencephalographic characteristics with clinical staging. Arch Neurol. 1987;44:1053–6.
26.
Espinar-SierraJToledanoMAFrancoC. Rett's syndrome: a neurophysiological study. Neurophysiol Clin. 1990;20:35–42.
27.
NiedermeyerENaiduS. Further EEG observations in children with the Rett syndrome. Brain Dev. 1990;12:53–54.
28.
RobertsonRLangillLWongPKHoHH. Rett syndrome: EEG presentation. Electroencephalogr Clin Neurophysiol. 1988;70:388–395.
