Encephalopathy with status epilepticus during sleep (ESES) induced by oxcarbazepine in idiopathic focal epilepsy in childhood

Abstract

SummaryEncephalopathy with status epilepticus during sleep (ESES) is an age-related disorder characterized by neuropsychological regression, epilepsy and a typical EEG pattern of continuous epileptiform activity (> 85%) during NREM sleep. Cases of worsening or induction of ESES with phenytoin, carbamazepine and phenobarbital have been reported. We describe a child with benign epilepsy with centrotemporal spikes (BECTS) in whom treatment with oxcarbazepine (OXC) induced ESES. The patient was studied through repeated clinical-neuropsychological evaluations and 24-hour EEG recordings. He was treated with OXC two months after epilepsy onset. One month after starting OXC, he developed an abrupt and severe cognitive deterioration. A 24-hour EEG and neuropsychological tests showed an electroclinical picture compatible with ESES. Withdrawal of OXC and introduction of other drugs were followed by a prompt improvement. Five months after ESES onset, a 24-hour EEG was normal. Our report indicates that OXC can induce ESES in BECTS. KEY WORDS: antiepileptic drugs (AEDs), benign epilepsy of childhood with centrotemporal spikes (BECTS), encephalopathy with status epilepticus during sleep (ESES), idiopathic focal epilepsies of childhood, oxcarbazepine (OXC).

Electrical Status Epilepticus during Sleep in a Male Filipino with Rare Nonsense Mutation Variant of Sotos Syndrome on Carbamazepine Monotherapy

“…Carbamazepine, phenytoin, phenobarbital, and oxcarbazepine were documented to induce ESES, typically presents with unexplained regression and stagnation of development. 7,8 The exact mechanism of drug-induced ESES is largely unknown but some proposed the involvement of channelopathy pathway as these drugs mostly act on specific ion channels in the nervous system. 9 Clinical and electrographic resolution of ESES had been shown with conventional ASMs particularly high-dose benzodiazepines and valproic acid.…”

Continuous Spike–Waves during Slow Sleep Today: An Update

“…In children with benign focal epilepsy, ESES, associated with cognitive deterioration, can be induced by old ASMs, such as phenytoin, carbamazepine, and phenobarbital, but also by a relatively new antiepileptic drug such as oxcarbazepine. In these cases, the therapy change is followed by a prompt electroclinical improvement [228].…”