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Research paper

Rebuilding the Tower of Babel: The Current Landscape of DEE-SWAS

Current-landscape review. Despite 2022 ILAE standardization, DEE-SWAS groups continue using variable SWI thresholds, treatment algorithms, and outcome measures. Consolidation around IV pulse steroids, benzodiazepines, and (in eligible cases) surgery is emerging but incomplete. Recommends standardization of SWI quantification and trial inclusion criteria.

Indexed context

Stowe RC, et al.

dee-swasnosologyreviewcurrent-landscape

Markdown path

content/research/papers/2025-stowe-dee-swas-tower-of-babel.md

Findings

Current-landscape review. Despite 2022 ILAE standardization, DEE-SWAS groups continue using variable SWI thresholds, treatment algorithms, and outcome measures. Consolidation around IV pulse steroids, benzodiazepines, and (in eligible cases) surgery is emerging but incomplete. Recommends standardization of SWI quantification and trial inclusion criteria.

Why it may matter for Levi

Background context for why different providers describe Levi's syndrome with slightly different vocabularies and why protocols vary across centers. Supports framing Levi's care as 'reasonable-range' rather than 'protocol-deviant' for the steroid taper duration and ASM selection choices.

Paper text

Stowe et al. (2025) — Current landscape of DEE-SWAS ("Tower of Babel")

Source

  • PMC12149166. Current-landscape narrative review.

Why in corpus

Frames the ongoing nosological and diagnostic heterogeneity in the DEE-SWAS field after the 2022 ILAE reclassification. Useful companion to the Specchio 2022 canonical classification paper.

Key findings

  • Despite 2022 ILAE standardization, DEE-SWAS research groups continue to use variable SWI thresholds, variable treatment algorithms, and variable outcome measures — the "Tower of Babel" problem.
  • Consolidation around IV pulse steroids, benzodiazepines, and (in eligible cases) surgery is emerging but incomplete.
  • Recommends standardization of SWI quantification, outcome measures, and clinical-trial inclusion criteria.

Levi-relevant takeaways

  • Background context for why different providers describe Levi's syndrome with slightly different vocabularies and why protocols vary across centers (Stanford, UCSF, and international references).
  • Supports framing Levi's care as "reasonable-range" rather than "protocol-deviant" — specifically the steroid taper duration and ASM selection choices.
  • No direct clinical action item.