Is ESES/CSWS a strictly age-related disorder?

Objectives: We report on a case of ESES/CSWS observed in a patient of 21 years and still persisting at the age of 25. Cases of ESES/ CSWS have never been previously described in adult patients. ESES/CSWS is considered to be related to the degree of maturation of the central nervous system, and therefore strictly age-related. Methods: Our case of ESES/CSWS was observed in a 21 year old woman referred for cognitive and behavioral disorders. She had previously had epileptic ®ts, but was seizure free at that time. The patient underwent a full-night polygraphic recording, which showed a typical ESES/CSWS pattern, with a Spike-and-Wave Index .85%. Polysomnography was repeated 9 times in a 4 year follow-up, during which the ESES/CSWS condition persisted, despite the pharmacological treatments. The patient also underwent cerebral magnetic resonance imaging and ¯udeoxyglucose 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 signi®cant difference between subcortical structures and cortical mantle was seen. MRI scans were normal. Conclusions: This observation suggests that ESES/CSWS might not always be an age-related condition. Sleep EEG recordings should always be performed in patients with behavioral disorders and a history of epileptic ®ts. q2000 Elsevier Science Ireland Ltd. All rights reserved.