Treatment of electrical status epilepticus during slow-wave sleep with high-dose corticosteroid.

Abstract

A 4-year-old female patient with epilepsy with continuous spike-and-waves during slow-wave sleep not classified as Landau-Klefner syndrome, refractory to antiepileptic drugs including valproate, benzodiazepines, and lamotrigine, was treated successfully with high-dose intravenous methylprednisolone therapy. Valproate, clobazam, and lamotrigine were continued at the same dose during and after high-dose intravenous corticosteroid therapy. During corticosteroid therapy, awake and sleep electroencephalogram was recorded every day. On day 7, a dramatic clinical and electroencephalographic response was observed. After high-dose intravenous methylprednisolone, prednisolone was administered orally (2 mg/kg daily) for 2 months, then gradually withdrawn. After the withdrawal of corticosteroid therapy, the patient maintained the clinical improvement in behavior, and no continuous spike-and-wave electrical status epilepticus during slow-wave sleep occurred on routine monthly sleep electroencephalogram performed for the last 6 months. In the present case, an add-on high-dose intravenous corticosteroid seems to be effective in the treatment of patients with electrical status epilepticus during slow-wave sleep syndrome, especially when antiepileptic drugs fail.

• Authors: Cetin Okuyaz, Kürşad Aydin, Kivilcim Gücüyener, Ayşe Serdaroğlu
• Journal: Pediatric neurology (Pediatr Neurol) Vol. 32 Issue 1 Pg. 64-7 (Jan 2005) ISSN: 0887-8994 [Print] United States
• PMID: 15607609 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anticonvulsants
• Glucocorticoids
• Methylprednisolone

Topics

• Anticonvulsants (therapeutic use)
• Child, Preschool
• Drug Resistance
• Electroencephalography
• Female
• Glucocorticoids (administration & dosage)
• Humans
• Methylprednisolone (administration & dosage)
• Sleep
• Status Epilepticus (diagnosis, drug therapy)