Short-Term Response of Sleep-Potentiated Spiking to High-Dose Diazepam in Electric Status Epilepticus During Sleep

• Published in: Pediatric neurology Vol. 46; no. 5; pp. 312 - 318
• Main Authors: Sánchez Fernández, Iván, MD, Hadjiloizou, Stavros, MD, Eksioglu, Yaman, MD, Peters, Jurriaan M., MD, Takeoka, Masanori, MD, Tas, Emir, MD, Abdelmoumen, Imane, MD, Rotenberg, Alexander, MD, PhD, Kothare, Sanjeev V., MD, Riviello, James J., MD, Loddenkemper, Tobias, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.2012; Elsevier
• Subjects: Adolescent; Age; Anticonvulsants - therapeutic use; Biological and medical sciences; Brain Waves - drug effects; Child; Child, Preschool; Children; Diazepam; Diazepam - therapeutic use; Dose-Response Relationship, Drug; Electroencephalography; Epilepsy; Female; Firing pattern; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Male; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Pediatrics; Retrospective Studies; Side effects; Sleep (NREM); Sleep - drug effects; Sleep - physiology; Sleep and wakefulness; Statistics, Nonparametric; Status Epilepticus - drug therapy; Status Epilepticus - physiopathology; Time Factors; Wakefulness - drug effects; Short term; Nervous system diseases; Sleep; Subintrant crisis; Epilepsy; Central nervous system disease; Sleep wake cycle; High dose; Status epilepticus; Diazepam; Cerebral disorder
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2012.02.017

Abstract We describe the short-term effects of high-dose oral diazepam on sleep-potentiated epileptiform activity in patients with electric status epilepticus during sleep. We enrolled patients treated with high-dose oral bedtime diazepam from 2001-2009. We defined spike percentage as the percentage of 1-second bins containing at least one spike, and calculated it during three randomly selected 5-minute samples of wakefulness throughout the day and during the first 5 minutes of every hour of non-rapid eye movement sleep at night. In this study, patients were considered to demonstrate sleep-potentiated epileptiform activity when their spike percentage during sleep was increased by ≥50% compared with wakefulness. Twenty-nine children (18 boys) were included (median age, 7.4 years). Twenty-four hours after receiving high-dose diazepam, epileptiform activity was significantly reduced (76.7% at baseline vs 40.8% 24 hours after high-dose diazepam; Wilcoxon signed ranks test, Z = −4.287, P < 0.0001). Seven patients (24.1%) manifested mild, reversible side effects during the first 48 hours after diazepam administration. High-dose oral diazepam effectively and safely reduced epileptiform activity in patients with electric status epilepticus during sleep.