Escobar Fernández Laura, Coccolo Góngora Alejandra, Vázquez López María, Polo Arrondo Ana Paloma, Miranda Herrero María Concepción, Barredo Valderrama Estíbaliz, Castro de Castro Pedro
Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, España.
Sección de Neuropediatría, Hospital Materno Infantil Gregorio Marañón, Madrid, España.
An Pediatr (Engl Ed). 2019 Sep;91(3):180-188. doi: 10.1016/j.anpedi.2018.12.016. Epub 2019 Feb 14.
Continuous spikes and waves during slow sleep (CSWS) is an EEG pattern that appears during childhood, and is often associated with cognitive impairment. It can appear in the course of epileptic syndromes, as well as in benign epilepsy. The aim of this study is to analyse epidemiological and clinical characteristic of patients with CSWS, in order to describe possible predictive factors in their outcome.
A retrospective study was conducted on paediatric patients with CSWS treated in a third-level hospital from November 1997 to November 2017.
The study included 25 patients (68% male), of whom 76% had abnormalities in the neuroimaging or suffered from psychomotor development disorder (secondary CSWS). The rest were healthy, or diagnosed with idiopathic epilepsy. The mean age of onset of CSWS was 6.7 years, but earlier in the secondary CSWS cases. Symptoms were present during the CSWS episode in 72% of cases. All of them were treated with antiepileptic drugs, which were effective in 36%. CSWS stopped in 72%, and remission was longer if the CSWS onset occurred at an older age. One-third (33%) presented with sequelae, mostly cognitive and behavioural alterations. Outcome was poorer in those with secondary CSWS and, in those whose CSWS started at an earlier age and lasted longer.
The CSWS pattern, although rare, is still a therapeutic challenge. A close follow-up of the patients with epilepsy is important, especially if associated with cognitive impairment, in order to establish an early diagnosis and treatment.
慢波睡眠期持续棘慢波（CSWS）是一种出现在儿童期的脑电图模式，常与认知障碍相关。它可出现在癫痫综合征过程中，也可出现在良性癫痫中。本研究旨在分析CSWS患者的流行病学和临床特征，以描述其预后可能的预测因素。
对1997年11月至2017年11月在一家三级医院接受治疗的小儿CSWS患者进行回顾性研究。
该研究纳入了25例患者（68%为男性），其中76%有神经影像学异常或患有精神运动发育障碍（继发性CSWS）。其余患者健康，或被诊断为特发性癫痫。CSWS的平均发病年龄为6.7岁，但继发性CSWS病例发病更早。72%的病例在CSWS发作期间出现症状。所有患者均接受抗癫痫药物治疗，其中36%有效。72%的患者CSWS停止，且如果CSWS发病年龄较大，缓解期更长。三分之一（33%）的患者出现后遗症，主要是认知和行为改变。继发性CSWS患者以及CSWS发病较早且持续时间较长的患者预后较差。
CSWS模式虽然罕见，但仍是一个治疗挑战。对癫痫患者进行密切随访很重要，尤其是伴有认知障碍的患者，以便早期诊断和治疗。
