Epileptic Encephalopathy With Spike-wave Activation in Sleep (EE-SWAS) Syndrome: Many Questions, Few Answers

Topic: Epileptic Encephalopathy With Spike-wave Activation in Sleep (EE-SWAS) Syndrome: Many Questions, Few Answers.
Talk By: Dr. Aradhana Rohil (Speaker), Dr. Ankit Meena (Speaker), Dr. Prashant Jauhari (Expert Faculty), Prof. Rajesh Ramachandran Nair (Panelist).
When: Saturday, August 17, 2024, at 09:00-10:00 AM Eastern Time (US/Canada).

Dr. Aradhana Rohil, MD
Resident trainee in Child Neurology at the Department of Pediatrics, AIIMS, New Delhi, India. Currently, she is working as a resident trainee in the child neurology division of the Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. Dr. Ankit Meena, MD, DM, Assistant Professor, Department of Pediatrics, AIIMS Bhatinda, India. Currently, he is working as a Pediatric Neurologist (Assistant Professor) in the Department of Pediatrics at All India Institute of Medical Sciences, Bhatinda, India.

Dr Prashant Jauhari, MD, DM
Additional Professor of Child Neurology, Department of Pediatrics, AIIMS, New Delhi, India. He is the current treasurer of the Association of Child Neurology in India. He has made significant contributions to the field of pediatric neurology, evidenced by over 80 publications in indexed journals and more than 30 book chapters in leading pediatric and pediatric neurology textbooks. He is the Principal Investigator on numerous extramural and intramural funded projects, focusing on areas such as EE-SWAS and immune-mediated epilepsies, as well as the application of transcranial magnetic stimulation (TMS) in pediatric epilepsy and movement disorders.

Prof Rajesh Ramachandran Nair, MD, FRCP, FRCPCH, FAES, FRCPC
Professor, McMaster University, Neurologist & Epileptologist, McMaster Children's Hospital. He has been a pediatric epileptologist & neurologist at the McMaster Children's Hospital since 2006. He was the founding medical director of the Comprehensive Pediatric Epilepsy Program. His clinical care focus is medically refractory epilepsy, Ketogenic Diet, and DEE/EE with Sleep Activation of Spike & Wave (SASW). Dr Ramachandran Nair is a program director for the International Child Neurology Teaching Network (ICNTN) by the International Child Neurology Association (ICNA). He is a member of the Adapt and Implementation Task Force of the International League Against Epilepsy (ILAE) Standards and Best Practice Council. Dr. Ramachandran Nair was the founding Program Director of the Canadian Epilepsy Teaching Network (CETN) by the Canadian League Against Epilepsy (CLAE) 2020-2024. He was a member of the department tenure & promotion committee and the coordinator of the Pediatric Neurology Rounds. He is the Project ECHO (Epilepsy across the life span) Co-Hub lead for the McMaster Children's Hospital. Dr. Ramachandran Nair is a researcher in the ketogenic diet, DEE/EE with Sleep Activation of Spike & Wave (SASW), and SUDEP Communication, and is funded by the Ontario Brain Institute.

About the session: Epileptic encephalopathy with spike-wave activation in sleep (EE-SWAS) is an intriguing epileptic syndrome hallmarked by relentless unexplained cognitive and behavioral regression along with sleep potentiated near continuous spike-wave discharges. The frequent change in nomenclature, the clinical phenotype, and the debate on EEG (Spike-wave-index cut-off) criteria make EE-SWAS baffling for a young child neurologist. However, what makes it truly enigmatic is our inability to fully understand its pathophysiology, role of the thalamus, neuroinflammation, neural circuitry, and the cause for the progressive neurobehaviour decline. Understandably, no universal consensus exists on the management protocol (steroids, antiepileptic drugs, antipsychotics) for EE-SWAS. We have tried to provide a few answers through our own research and from the available literature.

Case Titles:

Case 1: Discuss the evolution of a case with ANEC who later developed EE-SWAS

Case 2: Case highlighting management of presumed genetic EE-SWAS by a novel modality (inhibitory rTMS).

By attending this session, you will be able to learn the following points:

• To know the clinical & electrographic diagnostic criteria of EE-SWAS.
• To try to understand the pathophysiology of EE-SWAS.
• To discuss the neural circuitry of EE-SWAS.
• To understand 'remote inhibition' of the motor cortex in EE-SWAS.
• Management outline of EE-SWAS.