CSWS (Continuous spike and wave during slow wave sleep)
- 1% of all epilepsy in childhood
- Clinical onset usually 4-5 years old.
- Usually- but not always- due to structural brain damage.
- Landau Kleffner Syndrome (Acquired Epileptic Aphasia (AEA)) is a subtype of CSWS, with progressively loss of receptive and expressive language ability.
- Deterioration in development
- Different types of seizures can be seen (sometimes after typical Rolandic epilepsy).
- Speach disturbances (in fluency, understanding): When this symptom is prominent, LKS diagnosis is more likely.
- Behavioural problems and memory disturances: When this symptom is prominent, CSWS syndrome (or nocturnal frontal lobe epilepsy, NFLS) is more likely.
- Main feature is ESES (Electrical Status Epilepticus of Sleep) : synchronic discharges during NON REM sleep
- Discharges are seen in 70-80% of the time during NON REM sleep
ESES (Electrical Status Epilepticus of Sleep) in a 5.5-year-old girl with CSWS (double banana)
Author: Bas Jongbloed, MD, neurology resident, ETZ Tilburg, The Netherlands