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Electrical Status Epilepticus During Sleep: a Case Report of Postmorbid Baseline Evaluation

  • Case Study
  • Published:
Journal of Pediatric Neuropsychology Aims and scope Submit manuscript

Abstract

Objective

An 8-year-old, Caucasian, and right-handed female presented for a baseline neuropsychological evaluation due to diagnosis of electrical status epilepticus during sleep (ESES) preceded by postictal, late-night discovery of the patient on the floor and subsequent overnight electroencephalography. This first recognized seizure was tonic-clonic.

Method

The patient was born at 39 weeks gestation weighing approximately 5 lb, subsequently spending 48 h in NICU due to low birth weight and hypoglycemia. Developmental milestones were recalled within normal limits (WNL). The patient is prescribed levetiracetam, clobazam, and acetazolamide and has undergone multiple EEGs since diagnosis. Remaining medical history unremarkable including absence of known head trauma. Family history is remarkable for anxiety and developmental disability.

Results

Tests suggest global impairment, particularly in motor abilities and processing speed. Academic achievement is average across basic reading and writing, but verbal learning and memory are significantly diminished unless in story form. Evidence of impulsivity and inattention were present along with deficits in mathematics. Affect recognition was intact and tests of cognitive flexibility and planning were discontinued.

Conclusion

ESES generally presents early and results in neuropsychological deficits that are dependent upon length of condition and frequency and intensity of seizures. While deficits may improve when ESES subsides in pre-pubescence, some may persist into adulthood with high outcome variability. Baseline and ongoing neuropsychological testing are critical to early, targeted interventions and ongoing care. When early baselines are not feasible, it is important to construct a detailed, data-driven conceptualization to accommodate potential factors involved in notable deficits.

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Authors and Affiliations

  1. Department of Behavioral Sciences, Rush NeuroBehavioral Center, Rush University Medical Center, 4711 Golf Road, Suite 1100, Skokie, IL, 60076, USA

    Jack C. Lennon, Elizabeth DiMaggio & Ashley Lambert

  2. Department of Psychology, Adler University, 17 North Dearborn Street, Chicago, IL, 60602, USA

    Jack C. Lennon

  3. Department of Neurological Sciences, Section of Parkinson’s Disease & Movement Disorders, Rush University Medical Center, 1725 West Harrison Street, Suite 755, Chicago, IL, 60612, USA

    Jack C. Lennon

  4. Chicago School of Professional Psychology, 325 North Wells Street, Chicago, IL, 60654, USA

    Elizabeth DiMaggio

Authors
  1. Jack C. Lennon
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  2. Elizabeth DiMaggio
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  3. Ashley Lambert
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Correspondence to Jack C. Lennon.

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Human and Animal Rights in Informed Consent

In this case report, the cited articles contain studies with human and/or animal work approved by institutional review boards prior to publication.

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Informed consent to neuropsychological testing and research were obtained from the patient’s legal guardian. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Lennon, J.C., DiMaggio, E. & Lambert, A. Electrical Status Epilepticus During Sleep: a Case Report of Postmorbid Baseline Evaluation. J Pediatr Neuropsychol 6, 44–60 (2020). https://doi.org/10.1007/s40817-020-00077-4

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  • DOI: https://doi.org/10.1007/s40817-020-00077-4

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