Epilepsy with continuous spikes and waves during slow sleep (CSWS) is a rare neurological disease which is characterized by Electrical status epilepticus in slow‐wave sleep (ESES)

Objective: This study describes the electro clinical spectrum and treatment modalities in children with CSWS attending the Epilepsy clinic of a tertiary care centre in North India.

Methods: Retrospective analysis of the clinical and electroencephalographic characteristics, treatment and prognosis in 16 children diagnosed with CSWS was performed.

Results: All boys aged between 10 months and 12 years (mean age: 3.58 years) were affected. They had variable seizure types mostly comprising of generalized tonic clonic and atonic seizures. The majority children had an unknown etiology. Perinatal events causing CSWS were seen in 2 cases and postnatal meningitis was seen in 1 child. The epilepsy was pharmacoresistant in most cases requiring steroids and multiple antiepileptic drugs. Hyperactivity and behavioural abnormalities were common comorbidities along with cognitive and language regression. One child had clinical characteristics of rolandic epilepsy with EEG suggestive of CSWS.

Conclusion: Fall during seizures is an important characteristic that could be used for early clinical diagnosis of CSWS. For the patients those with multiple forms of epilepsy and stagnation or retrogression in cognitive development, monitoring EEG should be performed in order to avoid misdiagnosis. Steroids combined with antiepileptic drugs had a good effect on the treatment and the prognosis of CSWS.