Vagus Nerve Stimulation for Electrographic Status Epilepticus in Slow-Wave Sleep - 23/06/16

Doi : 10.1016/j.pediatrneurol.2016.02.016

Christopher M. Carosella, MD ^a, Hansel M. Greiner, MD ^a, Anna W. Byars, PhD ^a, Todd M. Arthur, MD ^a, James L. Leach, MD ^b, Michele Turner, CNP ^a, Katherine D. Holland, MD, PhD ^a, Francesco T. Mangano, DO ^c, Ravindra Arya, MD, DM ^a,^⁎
^a Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
^b Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
^c Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio

^∗Communications should be addressed to: Dr. Arya; Division of Neurology; Cincinnati Children's Hospital Medical Center; E4-145; MLC 2015; 3333 Burnet Avenue; Cincinnati, Ohio 45229.Division of NeurologyCincinnati Children's Hospital Medical CenterE4-145MLC 20153333 Burnet AvenueCincinnatiOhio45229

Abstract

Background

Electrographic status epilepticus in slow sleep or continuous spike and waves during slow-wave sleep is an epileptic encephalopathy characterized by seizures, neurocognitive regression, and significant activation of epileptiform discharges during nonrapid eye movement sleep. There is no consensus on the diagnostic criteria and evidence-based optimal treatment algorithm for children with electrographic status epilepticus in slow sleep.

Patient Description

We describe a 12-year-old girl with drug-resistant electrographic status epilepticus in slow wave sleep that was successfully treated with vagus nerve stimulation. Her clinical presentation, presurgical evaluation, decision-making, and course after vagus nerve stimulator implantation are described in detail.

Findings

After vagus nerve stimulator implantation, the girl remained seizure free for more than a year, resolved the electrographic status epilepticus in slow sleep pattern on electroencephalography, and exhibited significant cognitive improvement.

Conclusion

Vagus nerve stimulation may be considered for electrographic status epilepticus in slow sleep.

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Keywords : electrographic status epilepticus in slow sleep, continuous spike and waves during slow-wave sleep (CSWS), vagus nerve stimulation (VNS), epilepsy surgery

Plan

Introduction

Patient Description

Discussion

Disclosures and Conflict of Interest Statements: None of the authors has any disclosures pertinent to the current article.

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Vol 60

P. 66-70 - juillet 2016 Retour au numéro

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Vagus Nerve Stimulation for Electrographic Status Epilepticus in Slow-Wave Sleep - 23/06/16

Abstract

Background

Patient Description

Findings

Conclusion

Plan

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