Benign partial epilepsy with centrotemporal (or rolandic) spikes and brain lesion

Area of Science:

• Neurology
• Pediatric Neurology
• Epileptology

Background:

• Benign partial epilepsy with centrotemporal spikes (BECT) is a common childhood epilepsy syndrome.
• The presence of brain lesions can complicate epilepsy diagnosis and classification.
• Distinguishing epilepsy etiology is crucial for prognosis and management.

Observation:

• Three pediatric patients presented with clinical and EEG features consistent with BECT.
• Each patient had a confirmed, distinct brain lesion: agenesis of the corpus callosum, lipoma of the corpus callosum, or congenital toxoplasmosis.
• Epileptic seizures were well-controlled, and favorable outcomes were observed even after medication withdrawal.

Findings:

• The diagnosis of BECT was established despite the presence of structural brain abnormalities.
• Clinical presentation, EEG patterns, and treatment response supported the benign nature of the epilepsy.
• The epilepsy was considered fortuitously associated with the brain lesions, not caused by them.

Implications:

• Brain lesions should not automatically be attributed as the cause of BECT in affected children.
• Accurate diagnosis of BECT is possible even in the presence of concurrent brain pathologies.
• This highlights the importance of considering epilepsy syndrome characteristics over incidental findings for optimal patient management.