Electrical status epilepticus of sleep (ESES) refers to the occurrence of continuous epileptiform activity for at least 85% of slow-wave sleep. This syndrome is also known as epilepsy with continuous spike waves during slow-wave sleep. The syndrome was first described by Patry (1971). The EEG is characterized by generalized spike-wave complexes at 2-2.5 Hz. There is a marked attenuation of the pattern during REM sleep and in the wake EEG. The condition almost always occurs in patients with a prior history of epilepsy. With the onset of ESES, there is an associated decline in cognitive function with improvement once the ESES has resolved (Jayakar and Seshia, 1991). Seizures may manifest as nocturnal focal motor or generalized tonic-clonic seizures, or as atypical absence or myoclonic seizures.
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