Overreliance on EEG Normalization: A Case Report of DEE-SWAS Treated as Presumed NCSE Leading to Avoidable Escalation

By
Wu, Jie
Deng, Jie
Xu, Manting
Huang, Liyi
Zhao, Guangyuan
May 6, 2026
0 min

Frontiers In Pediatrics

Overview

This report discusses a case of a 10-year-old boy misdiagnosed with non-convulsive status epilepticus due to EEG misinterpretation. The case highlights the importance of accurately distinguishing between electrical status epilepticus during sleep and non-convulsive status epilepticus to prevent unnecessary and harmful treatments.

Background

Accurate diagnosis of seizure types is critical in pediatric patients, particularly in cases of developmental and epileptic encephalopathy. Misinterpretation of EEG findings can lead to inappropriate treatment strategies, which may result in significant complications and prolonged hospital stays. Understanding the nuances of EEG patterns is essential for optimizing patient outcomes and minimizing risks associated with misdiagnosis.

Data Highlights

No numerical data or trial data presented in the article.

Key Findings

A 10-year-old boy was misdiagnosed with non-convulsive status epilepticus due to EEG findings.
The misdiagnosis led to an unnecessary anesthesia-induced coma, resulting in severe complications.
Discontinuation of anesthetics and adjustment of antiepileptic treatment led to recovery, despite persistent EEG abnormalities.
The case emphasizes the need for careful differentiation between ESES and NCSE.
Overreliance on EEG normalization without risk-benefit assessment can lead to detrimental outcomes.

Clinical Implications

Clinicians should exercise caution when interpreting EEG findings, particularly in pediatric patients with complex seizure disorders. A thorough clinical correlation and risk-benefit analysis are essential before initiating aggressive treatments such as anesthesia-induced coma.

Conclusion

This case underscores the critical importance of accurate EEG interpretation in pediatric epilepsy management. It serves as a reminder to prioritize clinical context and comprehensive evaluation to avoid misdiagnosis and unnecessary interventions.