Clinical and Neuro Electrophysiological Outcome of Intravenous Pulse Methylprednisolone Therapy in Children with Continuous Spike and Waves during Slow Sleep: A Self-Controlled Clinical Trial

Author(s): Dr. Gulsan-Ara-Zahan*, Prof Gopen Kumar Kundu, Dr. SK. Serjina Anwar

Introduction: Continuous Spike-Wave during Slow Sleep (CSWS) is a complex epileptic encephalopathy in children characterized by seizures, neurocognitive decline, and Electrical Status Epilepticus during slow sleep (ESES). Despite its severe impact, there is a lack of consensus on effective treatment protocols. This study aimed to evaluate the efficacy of intravenous methylprednisolone (IV MP) pulse therapy in managing CSWS.

Methods: This single-center, self-controlled trial study was conducted involving 38 children diagnosed with CSWS at the Department of Neurology at BSMMU, Bangladesh, from June 2021 to May 2022. Participants underwent IV MP pulse therapy for five cycles, and their clinical seizure frequency, EEG outcomes, and psychological assessments were monitored and analyzed.

Result: Significant improvements were observed in clinical seizures, with 97.37% of participants showing improvement after the 5th cycle of IV MP pulse therapy. EEG outcomes also showed marked improvement, with a p-value of <0.001 indicating statistical significance. Psychological assessments revealed an improvement in cognitive function, further substantiating the therapy's efficacy.

Conclusion: The study demonstrates the promising potential of IV MP pulse therapy in treating CSWS, showing significant improvements in clinical seizures, EEG outcomes, and psychological status. Despite limitations like the single-center design and short study duration, these findings offer a valuable contribution to the existing literature and pave the way for future multi-center, randomized trials.