%0 Journal Article
%T High incidence of early thalamic lesions in the Continuous Spike-Wave related with slow Sleep (CSWS).
%A Carvalho D
%A Mendonça C
%A Carvalho J
%A Martins A
%A Leal A
%J Epilepsy Behav
%V 138
%N 0
%D 01 2023
%M 36512931
%F 3.337
%R 10.1016/j.yebeh.2022.109031
%X Continuous Spike-Wave during slow Sleep (CSWS) syndrome associates a clinically important neurocognitive regression with strong activation of non-REM sleep spikes. Its mechanisms remain unknown, but a contribution of rare perinatal thalamic injuries has been highlighted. We determine the incidence of such lesions in a cohort of CSWS patients.<BR>N = 65 patients with CSWS and a control group (N = 51) were studied. Spikes were quantified in long-term ambulatory EEGs, brain Magnetic Ressonance Imaging (MRI) structural lesions were assessed and thalamic volumetry was performed. A neurocognitive scale was used to assess dysfunction.<BR>The most common etiologies in the control patients were not represented in the CSWS group. Structural lesions were detected in a minority of CSWS patients (25/53) but included a thalamic injury in the large majority (24/25). This ratio was 4/40 in controls. Lesions belonged to one of five types: 1. Circumscribed to the thalamus (N = 11); 2. Extending beyond the thalamus (N = 3); 3. Hypothalamic-Hamartomas (N = 4); 4. Periventricular-Leukomalacia (N = 4); 5. Hypoplasia-Polymicrogyria (N = 1). Most lesions were lateralized to one hemisphere, which in all cases corresponded to the lateralization of the CSWS.<BR>Thalamic lesions are present in most CSWS patients with abnormal MRIs, supporting an important role in its genesis.