Is ESES/CSWS a strictly age-related disorder?

Objectives: We report on a case of ESES/CSWS observed in a patient of 21 ye ars and still persisting at the age of 25. Cases of ESES/CSWS have never be en previously described in adult patients. ESES/CSWS is considered to be re lated to the degree of maturation of the central nervous system, and theref ore strictly age-related. Methods: Our case of ESES/CSWS was observed in a 21 veer old woman referred for cognitive and behavioral disorders. She had previously had epileptic f its, but was seizure free at that time. The patient underwent a full-night polygraphic recording, which showed a typical ESES/CSWS pattern, with a Spi ke-and-Wave Index >85%. Polysomnography was repeated 9 times in a 4 year fo llow-up, during which the ESES/CSWS condition persisted, despite the pharma cological treatments. The patient also underwent cerebral magnetic resonanc e imaging and fludeoxyglucose F 18 positron emission tomography (PET). Results: The PET study revealed reduced metabolic activity within the lower gyrus of the right parietal lobe, but no significant difference between su bcortical structures and cortical mantle was seen. MRI scans were normal. Conclusions: This observation suggests that ESES/CSWS might not always be a n age-related condition. Sleep EEG recordings should always be performed in patients with behavioral disorders and a history of epileptic fits. (C) 20 00 Elsevier Science Ireland Ltd. All rights reserved.