Abstracts

Rationale: ESES is an electrographic pattern in which interictal epileptiform activity is augmented by the transition to sleep, with the non-rapid eye movement (NREM) sleep state characterized by near-continuous lateralized or bilateral epileptiform discharges. The ESES pattern is a key electrographic feature in several pediatric onset clinical syndromes with neurocognitive impacts ranging from mild to severe. Timely diagnosis and management are critical to mitigate impact. Currently, long-term monitoring (LTM) studies are standard of care to evaluate patients who are suspected of having ESES. These studies can be socially and financially burdensome for families. Our aim was to compare the spike-wave index (SWI) through LTM with the first 100 seconds of sleep in a comparable routine EEG to determine whether routine EEGs can be a reliable scoring method to determine ESES.

Methods: Over 340 LTM taken for concern for ESES were reviewed and comparable routine EEGs were determined. Comparable routine EEG were determined to be taken within 6 months, have the exact same medication regimen, and involve sleep. A total of 25 routine EEGs met the inclusion criteria. Two neurophysiologists calculated the SWI of the first 100 seconds of sleep, the first 5 minutes of sleep, and three separate 5 minute periods in the beginning, middle, and end of sleep of these LTM. These were then compared with the SWI of the first 100 seconds of sleep obtained through comparable routine EEG. Agreement between these methods were analyzed using several statistical tools.

Results: Results from a previous study¹ showed the validity of using the first 100 seconds of sleep of LTM to score ESES. This study builds upon this method by calculating the SWI of the first 100 seconds of sleep obtained through comparable routine EEG. Early analysis of the specificity and sensitivity of this method are promising. If successful, routine EEGs with components of sleep can replace some LTM studies to evaluate a patient who is suspected of having ESES.

Conclusions: Statistical analysis is currently being completed and early indications are promising for the use of routine EEGs as a reliable scoring method for ESES. If successful, this will be a more time efficient and cost-effective way to provide diagnostic evaluation for patients with concern for ESES.
_x000D_ Reference:_x000D_ 1. Kulkarni N, Albert DVF, Klamer B, Drees M, Twanow JD. The spike-wave index of the first 100 seconds of sleep can be a reliable scoring method for electrographic status epilepticus in sleep [published online ahead of print January 7, 2022]. J Clin Neurophysiol. doi: 10.1097/WNP.0000000000000918

Funding: