Epileptiform discharges augmented during sleep: Is it a trait with diverse clinical presentation according to age of expression?

SummarySleep has long been viewed as a negative phenomenon; however, it is now clear that it is a period of intense brain activity involving higher cortical functions. Overall, sleep affects every aspect of a child's development, particularly higher cognitive functions. The seizure threshold is often affected by changes in the level of arousal, and many interictal EEG abnormalities are activated by sleep. Epileptiform discharges augmented during sleep are described in number of epileptic syndromes characterized by infrequent clinical seizures but significant cognitive deterioration, the prototype of which is the syndrome of continuous spike-wave discharges during sleep (CSWS). In this article the conditions sharing the same EEG feature of paroxysmal epileptiform discharges augmented during sleep and their overlap will be highlighted arguing whether these disorders may be clinical presentations of same trait when expressed at different stages of brain maturity, as well as the controversies in definition and management of cases without clinical seizures.