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Acetazolamide for electrical status epilepticus in slow‐wave sleep
Author(s) -
Fine Anthony L.,
Wirrell Elaine C.,
WongKisiel Lily C.,
Nickels Katherine C.
Publication year - 2015
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.13101
Subject(s) - status epilepticus , spike and wave , medicine , electroencephalography , pediatrics , acetazolamide , audiology , psychiatry , epilepsy , anesthesia
Summary Electrical status epilepticus in slow‐wave sleep ( ESES ) is characterized by nearly continuous spike–wave discharges during non–rapid eye movement ( REM ) sleep. ESES is present in Landau‐Kleffner syndrome ( LKS ) and continuous spike and wave in slow‐wave sleep ( CSWS ). Sulthiame has demonstrated reduction in spike–wave index ( SWI ) in ESES , but is not available in the United States. Acetazolamide ( AZM ) is readily available and has similar pharmacologic properties. Our aims were to assess the effect of AZM on SWI and clinical response in children with LKS and CSWS . Children with LKS or CSWS treated with AZM at our institution were identified retrospectively. Pre‐ and posttherapy electroencephalography ( EEG ) studies were evaluated for SWI . Parental and teacher report of clinical improvement was recorded. Six children met criteria for inclusion. Three children (50%) demonstrated complete resolution or SWI <5% after AZM . All children had improvement in clinical seizures and subjective improvement in communication skills and school performance. Five of six children had subjective improvement in hyperactivity and attention. AZM is a potentially effective therapy for children with LKS and CSWS . This study lends to the knowledge of potential therapies that can be used for these disorders, which can be challenging for families and providers.