Abstract
Epilepsy with continuous spike-waves during slow sleep (CSWS) is characterized by
impairment of neuropsychological abilities, frequently associated with behavioral
disorders. These manifestations strongly correlate with frontal lobe dysfunctions.
CSWS in childhood may affect the prefrontal cortex and leave residual mental and behavioral
abnormalities as profound and permanent as the loss of speech in Landau-Kleffner syndrome.
In our previous volumetric studies, frontal and prefrontal lobe volumes revealed growth
disturbance in all CSWS patients compared with those of normal subjects. These studies
also revealed that in the patients with shorter seizure durations and CSWS periods,
developmental abnormalities of the prefrontal lobes were soon restored to a more normal
growth ratio, whereas growth disturbances of the prefrontal lobes were persistent
in the patients with longer seizure durations and CSWS periods. These findings suggest
that seizure and the duration of paroxysmal anomalies may be associated with prefrontal
lobe growth abnormalities, which are associated with neuropsychological problems.
Thus, the duration of CSWS period seems to be a significant prognostic factor. The
urgent suppression of this electroencephalography abnormality may be necessary to
prevent the progression of neuropsychological impairments. The best treatment options
may be required to remit seizures and electroencephalography abnormalities as soon
as possible to achieve optimal prognosis in CSWS.
Keywords
CSWS - cognition - behavior - prefrontal lobe - brain volumetry - MRI
