FOCAL CEREBRAL METABOLIC ABNORMALITY IN A PATIENT WITH CONTINUOUS SPIKE WAVES DURING SLOW-WAVE SLEEP

We report an 11-year-old boy with continuous spike-wave discharges dur ing sleep accompanied by partial motor and atypical absence seizures, psychomotor regression, and severe behavior problems. During wakefulne ss, epileptiform discharges occurred over the right parietal region, s uggesting that the continuous spike-wave discharges during sleep were a manifestation of secondary bilateral synchrony. Bilateral suppressio n of the spike-and-wave activity was observed after right-sided intrac arotid amobarbital injection, further supporting the impression of sec ondary bilateral synchrony. The right superior temporoparietal increas e in metabolic activity during continuous spike-wave discharges and no ncontinuous spike-wave discharges was seen on [F-18]fluorodeoxyglucose positron emission tomography and supports a right temporoparietal foc us in our case. The presence of a focal abnormality suggests that surg ical therapy may be effective.