Re: CSWS

Posted By peds neuro md bm on March 11, 1998 at 17:56:44:

In Reply to: CSWS posted by Joan Niertit on February 23, 1998 at 01:00:49:







: Our 9 y/0 daughter was born with a Grade IV IVH. She has had CSWS and seizures since at least 2 y/o; however, the CSWS was not diagnosed until about a year ago. She's been on a number of different AEDs, IVIG, and the ketogenic diet, which controlled the seizures as long as she was on it, but didn't so much for the spiking. She is currently on Tranxene, Clobazam, Vigabtrin, and the Atkins diet, which some have reported as being almost as effective as the ketogenic diet. (BTW, her urine ketone are usually about 80.) We are planning to start ACTH soon. Is there any conflict between the diet or any of the medications and ACTH?
CSWS as you know is continous sharp wave during sleep. As such they are
present when the child goes to sleep. This is a seizure pattern that is
considered benign and teansient. Although patients experience severe
epilepsy during CSWS, most seixures disappear spontaneously before or
near puberty. The seriousness of this condition is its effect on the
mental/cognitive state.
making a diagnosis of CSWS is sometimes difficult and may be confused
with other epilepsy entities. In epilepsy with CSWS, the seizures are
treated accordingly to type and treatment is not 100 percent effective.
The medications that your child is on at present are some of the therapies
that has yielded some partial control. Steroids may produce some
improvement, especially with the language perspective.
Answering your question are there any conflict with her medication,
diet and the ACTH. All modes of pharmaceutical therapy has side effects
ACTH on its own has major side effects. You will have to discuss with
your doctor the risk versus benefit of using ACTH and its combination
with her current medication. You may want to ask him also what his goal is
in using ACTH if this will haelp you decide what the next step will be.