Disorders of Electrical Status Epilepticus During Slow Sleep

Although electrical status epilepticus during slow sleep (ESES) is an electroencephalographic term, it designates a group of disorders covering epilepsy, cognitive/behavioral dysfunction, and motor neurologic symptoms. Its characteristic EEG finding is continuous spikes and waves during NREM sleep, which, according to some authors, should occupy at least 85% of this period. Disorders associated with electrical status epilepticus are of a wide spectrum, with a common characteristic feature of age-related increasing epileptogenic discharges during NREM sleep, which completely disappear or decrease to initial levels within months or years. However, behavioral or cognitive involvement may be lasting or even become permanent. These disorders are thought to be associated with the localization of focal discharges. Early and effective therapy aiming to decrease the duration of ESES may also help prevent permanent neuropsychological impairment, though no consensus exists as to the optimal treatment.