Archived AES Symposia 2006
Pediatric State of the Art Symposium - Continuous Epileptiform Discharges in Sleep: Pathophysiology, Clinical Spectrum, and Controversies in Treatment
Program Length: 2 hrs 8 min
Landau-Kleffner syndrome (LKS), electrical status epilepticus in slow wave sleep (ESES), and benign rolandic epilepsy of childhood (BREC) are three conditions in children that may show nearly continuous abnormal epileptiform discharges in sleep. Besides clinical seizures, it is commonly believed that abnormal electrical activity in sleep per se leads to cognitive, behavioral, and academic difficulties in these children. The program will begin with a discussion of possible underlying pathophysiological mechanisms/generators of abnormal EEG in sleep, similarities between sleep EEGs of these children and amygdala-kindled kittens, and how these findings help us think about treatment possibilities. We will then move on to discuss clinical spectrum, accurate diagnoses, neuroimaging findings, treatment, follow-up, and prognosis in these children. The program will allow for interaction of all the speakers with the audience and for discussion of potential future directions of research and new therapies.
At the conclusion of this activity, participants should be able to:
- Define the clinical spectrum and diagnoses of childhood epilepsies with continuous epileptic discharges in sleep (Landau-Kleffner syndrome [LKS], electrical status epilepticus in slow wave sleep [ESES], and benign rolandic epilepsy of childhood [BREC]), and explain the implications for treatment choices in each form of epilepsy
- Formulate goals of treatment for patients with LKS, ESES, and BREC, discuss treatment options (both old and new treatments) for each form of epilepsy, and describe current controversies in the management of these disorders
- Discuss possible pathophysiological mechanisms underlying these disorders, explain the possible implications of these mechanisms for treatment decisions, and identify future strategies for better treatment.
Child neurologists, adult neurologists, epilepsy specialists, and nurse practitioners.
Co-chairs: Ajay Gupta, M.D. and Mohamad Mikati, M.D.
Continuous Epileptiform Activity in Sleep: Pathophysiologic Mechanisms and Neurological Consequences
Margaret N. Shouse, Ph.D.
Clinical Spectrum and Terminology: Use and Abuse
Edouard Hirsch, M.D., Ph.D.
Treatment: What to Use and What to Target — Seizures, EEG, or Behavior?
James J. Riviello, Jr., M.D.
Future Directions: Open Discussion and Research Proposals
Disclaimer: Opinions expressed with regard to unapproved uses of products are solely those of the faculty and are not endorsed by the American Epilepsy Society or any manufacturers of pharmaceuticals.