TRANSIENT PSYCHOSIS IN A GIRL WITH EPILEPSY AND CONTINUOUS SPIKES ANDWAVES DURING SLOW SLEEP (CSWS)

A normally developed and healthy 6-year-old girl suffered the onset of epilepsy with generalized tonic-clonic seizures and atypical absences . Initially the EEG showed epileptiform activity over the temporal and parietal regions, later there were episodes of bilateral synchronous spike-wave activity with a frequency of 1.5-2.5 Hz. After a few months , deterioration of cognitive and behavioural functions appeared and gr adually increased with the development of a full-blown disintegrative psychosis that went on for several months. Sleep EEG recordings showed the characteristic abnormality described as continuous spikes and wav es during slow sleep. Later there was a remarkable improvement of neur opsychiatric functions but a second outbreak of psychosis seems to hav e left the girl, who is now 9 years of age, with severe mental impairm ent.