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Benign childhood epilepsy with centrotemporal spikes: is it always benign?

H T Ong1, E Wyllie

  • 1Department of Neurology, The Cleveland Clinic Foundation, OH 44195, USA.

Neurology
|March 17, 2000
PubMed

Insights

Most children with benign childhood epilepsy with centrotemporal spikes (BCECS) experience mild seizures. However, rare cases present with severe, intractable seizures and cognitive decline, yet surgical intervention may not be necessary as remission is likely.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Clinical Neuroscience

Background:

  • Benign childhood epilepsy with centrotemporal spikes (BCECS) is a common idiopathic epilepsy syndrome in children.
  • Typically characterized by infrequent seizures, BCECS often resolves spontaneously with age.

Observation:

  • This report details two pediatric cases with clinical and EEG findings indicative of BCECS.
  • These children presented with unusually severe, intractable seizures and significant cognitive decline, prompting evaluation for epilepsy surgery.

Findings:

  • Despite the severe presentation, spontaneous remission of seizures occurred in one child.
  • The other child, still young, exhibits ongoing severe seizure activity and cognitive impairment.

Implications:

  • The findings suggest that even in severe presentations of BCECS with cognitive decline, epilepsy surgery may be premature.
  • Conservative management should be considered, as spontaneous remission is a likely outcome in these rare, severe cases of childhood epilepsy.

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