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Cognitive and behavioral problems in children with centrotemporal spikes.
A W Yung1, Y D Park, M J Cohen
1Department of Neurology, Section of Child Neurology, Medical College of Georgia, Augusta, Georgia 30912, USA.
Pediatric Neurology
|December 19, 2000
Summary
Atypical features are common in benign epilepsy of childhood with centrotemporal spikes (BECTS), impacting neuropsychological functioning. Many children with BECTS experience learning or behavioral issues requiring intervention, with some showing language deficits similar to Landau-Kleffner syndrome.
Area of Science:
- Pediatric Neurology
- Epileptology
- Neurodevelopmental Disorders
Background:
- Benign epilepsy of childhood with centrotemporal spikes (BECTS) is typically associated with a benign prognosis.
- However, atypical features and long-term neuropsychological sequelae are increasingly recognized.
Observation:
- A retrospective review of 78 children (ages 2-16) with electroencephalogram-confirmed centrotemporal spikes was conducted.
- Exclusion criteria included structural lesions or other epileptic syndromes.
- Fifty-six children had clinical seizures consistent with BECTS, while 22 had spikes without seizures.
Findings:
- Among all children with centrotemporal spikes, significant percentages exhibited neurodevelopmental challenges: 9% mild intellectual disability, 10% borderline functioning, 31% behavioral problems, and 17% specific learning disabilities.
- Three children with BECTS experienced language delay and regression, mirroring outcomes seen in Landau-Kleffner syndrome (LKS) and continuous spikes and waves during slow sleep (CSWS).
- While seizure control in BECTS is generally good, these findings highlight prevalent learning and behavioral issues.
Implications:
- BECTS requires monitoring beyond seizure control, addressing potential learning and behavioral deficits.
- Early intervention is crucial for children with BECTS experiencing neurodevelopmental challenges.
- A subset of BECTS patients may require specialized interventions for language and cognitive outcomes, similar to those with LKS and CSWS.