COMPARISON OF CORTİCOSTEROİDS VERSUS CLOBAZAM TREATMENT OF EPİLEPTİC ENCEPHALOPATHY WİTH ELECTRİCAL STATUS EPİLEPTİCUS FOR ELECTROCLINICAL REMISSION

Objectives: The purpose of this study was to retrospectively compare electroclinical features, spike wave index (SWI) and subjective neuropsychological assessment as measures to evaluate treatment efficacy of clobasam versus corticosteroids after 6 months in children with Epileptic encephalopathy with electrical status epilepticus in sleep (ESES). Methods: We retrospectively included patients with ESES treated with either corticosteroids (intravenous methylprednisolone pulses or daily oral prednisolone) or oral clobazam for 6 months between January 2018-December 2021. Medical-files were evaluated for data concerning the caregiver responses regarding deterioration and improvement and with respect to clinical judgment. Clinical improvement was graded as full, more than 75%, more than 50% and less than 50%. Results: A total of 30 children received either corticosteroid or clobasam treatment for ESES and were included in the analysis. Eighteen received clobasam (1-1.2 mg/kg/day for 6 months) and 12 were treated with corticosteroids (monthly intravenous methylprednisolone or oral prednisolone). Nine out of twelve patients receiving corticosteroids had SWI reduction and six of them achieved a greater than 50% reduction in SWI. Sixteen patients receiving clobasam had SWI reduction and only six of them had an SWI reduction greater than 50% reduction (p = 0.001). We found that more patients receiving corticosteroid treatment, as compared to clobasam treatment, had a clinical imporovement more than 50% ( 6/12 vs 5/20, p: 0.001) . Conclusion: Compared with clobasam, corticosteroids were found to be more effective in clinical and electrographical assessments.