Abstract Details

Title Does the Reduction of Epileptiform Activity in Patients with Electrical Status Epilepticus in Sleep Treated with High-Dose Diazepam Persist over Time?

Topic Child Neurology/Developmental Neurobiology

Presentation(s) P03 - (-)

Poster/Presentation
Number 015

Objective

Background BACKGROUND: It is currently not known whether reductions in epileptiform activity following HDDZP treatment persist.

Design/Methods DESIGN/METHODS: We enrolled patients with ESES on EEG(minimum spike-wave index: 50%) during eight consecutive years. Inclusion criteria: 1) age 1-21 years, 2) at least one overnight EEG, 3) treatment with HDDZP (1 mg/Kg during the first night followed by 0.5 mg/Kg/night during following nights), and 4) at least one follow-up EEG that included sleep.

Results RESULTS: Seventeen patients (12 males) were included and underwent 23 cycles of HDDZP treatment. Their median (interquartile range) age at the first cycle of HDDZP treatment was 7.42 (5.59-9.71) years. After 24 hours of treatment, in 15 treatment cycles, a decrease of at least 25% of epileptiform activity was noted. Eleven of these treatment cycles had an available follow-up EEG at least 3 months after treatment and 8 (72.73%) demonstrated persistent decreases in epileptiform activity while 3 (27.27%) relapsed back to baseline epileptiform activity. Nine cycles had a reduction of at least 50% at 4 months. Of the 6 treatment cycles with a minimum 6-month follow-up EEG, all 6 (100%) had persistent reduction in epileptiform activity. The treatment with HDDZP was continued over 1 month (in 4 cycles of treatment), 2 months (6), 3 months (4), 5 months (2) and was discontinued during the first week in 7 cycles. The heterogeneous follow-up schedule did not allow statistical comparisons, yet patients who responded acutely continued to have persistent response.

Conclusions CONCLUSIONS: In patients with sufficient follow-up on EEG, the majority of children treated with HDDZP had a persistent reduction of spike-wave index. Acute reduction in epileptiform activity suggested persistence of this effect on longitudinal follow-up.

Authors/Disclosures
PRESENTER	No disclosure on file
Jurriaan Peters, MD (Boston Childrens Hospital)	Dr. Peters has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurelis. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neurelis. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jazz Pharmaceuticals. Dr. Peters has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Neurelis. Dr. Peters has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for CRICO. Dr. Peters has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for UCB.
	No disclosure on file
Noah Rosen, MD, FAAN	Dr. Rosen has received personal compensation for serving as an employee of Northwell Health. An immediate family member of Dr. Rosen has received personal compensation for serving as an employee of New York University. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Allergan/ Abbvie. Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lundbeck. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Pfizer . Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Rosen has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan/ Abbvie. Dr. Rosen has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Pfizer. Dr. Rosen has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer.
Ann M. Bergin, MD	No disclosure on file
Masanori Takeoka, MD (Children'S Hospital Boston)	No disclosure on file
Alexander Rotenberg, MD, PhD (Childrens Hospital)	Dr. Rotenberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Rotenberg has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Clinical Neurophysiology. Dr. Rotenberg has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for multiple. Dr. Rotenberg has stock in PrevEp. Dr. Rotenberg has stock in Neuromotion Labs. The institution of Dr. Rotenberg has received research support from Encoded. The institution of Dr. Rotenberg has received research support from Roche. The institution of Dr. Rotenberg has received research support from Biomarin. The institution of Dr. Rotenberg has received research support from CRE Medical. The institution of Dr. Rotenberg has received research support from Neuroelectrics. The institution of Dr. Rotenberg has received research support from SSADH Foundation. The institution of Dr. Rotenberg has received research support from Loulou Foundation. Dr. Rotenberg has received intellectual property interests from a discovery or technology relating to health care.
Sanjeev V. Kothare, MD, FAAN (Cohen Children's Hospital, Northwell Health)	Dr. Kothare has nothing to disclose.
Blaise F. Bourgeois, MD (Children's Hospital)	No disclosure on file
Tobias Loddenkemper, MD, FAAN	No disclosure on file

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