Use of Acetazolamide for Electrical Status Epilepticus During Slow-wave Sleep
Abstract number :
3.477
Submission category :
4. Clinical Epilepsy / 4C. Clinical Treatments
Year :
2023
Submission ID :
1227
Source :
www.aesnet.org
Presentation date :
12/4/2023 12:00:00 AM
Published date :
Authors :
Presenting Author: Mahjabeen Khan, MD – Baylor College of Medicine
Glen Fenton, MD – Saint Louis University School of Medicine; Himanshu Kaulas, MD – Saint Louis University School of Medicine
Rationale: We report the use of Acetazolamide (AZM) in a cohort of children with the EEG pattern of electrical status epileptics in slow-wave sleep (ESES).
Methods: We assembled a cohort of patients with an EEG pattern of ESES who were treated with AZM between January 2015 and October 2022 at an academic children's hospital. A retrospective chart review was done to retrieve data pertinent to demographics, dose, duration of treatment, efficacy and side effects of AZM.
Results: We reviewed a total of ten patients with ESES. Eight patients were prescribed AZM as a second-line medication for ESES, first being a benzodiazepine - diazepam or clobazam. Six patients tolerated the medication well while two discontinued due to side effects namely acidosis and encephalopathy. AZM was effective in four of the six patients (66%). All four patients not only showed cognitive and behavioral improvement, significant improvement on EEG was also noted. Spike-wave index (SWI) improved by more than 50% in these patients.
Conclusions: The literature is limited on AZM use for ESES. We note that AZM has shown efficacy (66%) comparable to BZDs (60% in other studies), both clinically and electrographically. Since, it is better tolerated we support the consideration of an AZM trial as a second-line medication in patients who have failed or did not tolerate BZDs, prior to initiation of steroids.
Funding: None
Clinical Epilepsy