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Clinical and Electroencephalographic (EEG) Features Associated With Refractoriness in Benign Childhood Epilepsy With
Fenglai Xiao1, Dongmei An1, Sihan Chen1
1Department of Neurology, West China Hospital, SiChuan University, Chengdu, Sichuan, People's Republic of China.
Insights
Identifying risk factors for refractory epilepsy in children is crucial. Diffusing electroencephalographic (EEG) foci and delayed treatment significantly increase the risk of persistent seizures in benign childhood epilepsy with centrotemporal spikes.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Neurophysiology
Background:
- Benign childhood epilepsy with centrotemporal spikes (BCECTS) is common.
- Some children experience refractory epilepsy despite initial treatment.
- Identifying predictors of treatment refractoriness is essential for effective management.
Purpose of the Study:
- To identify clinical and electroencephalographic (EEG) features associated with refractoriness to initial antiepileptic drug (AED) therapy in BCECTS.
- To explore risk factors contributing to delayed treatment in this population.
Main Methods:
- Retrospective analysis of 87 children diagnosed with typical BCECTS.
- Patients categorized into two groups: those controlled with monotherapy and those requiring two medications.
- Statistical analysis to identify significant risk factors (P < .001).
Main Results:
- Sixty-three children achieved seizure freedom with monotherapy; 24 required two medications.
- Diffusing foci on follow-up EEG and delayed treatment (>1 year) were significant risk factors for refractoriness.
- Delayed diagnosis (37.1%) and nonadherence (57.2%) contributed to delayed treatment.
Conclusions:
- Diffusing EEG foci and delayed treatment are key predictors of refractory epilepsy in BCECTS.
- Diagnostic delays and treatment nonadherence impede timely intervention, highlighting areas for improved patient care.
- Early identification of risk factors can optimize treatment strategies for children with BCECTS.
Abstract:
The aim of this study is to identify clinical or electroencephalographic (EEG) features associated with refractoriness to the initial antiepileptic drug in typical benign childhood epilepsy with centrotemporal spikes. A total of 87 children with typical benign childhood epilepsy with centrotemporal spikes were retrospectively reviewed in the analyses. The patients were subdivided into 2 groups: patients whose seizures were controlled with monotherapy and patients requiring 2 medications. Sixty-three children achieved seizure freedom with monotherapy, whereas 24 received 2 medications for seizure control. Diffusing foci at the follow-up EEG and delayed treatment (duration >1 year) are 2 main risk factors associated with more refractory cases (P < .001). Delayed diagnosis (37.1%) and nonadherence to treatment (57.2%) contributed to delayed treatment. Our findings suggested that diffusing foci on EEG and delayed treatment are associated with more frequent seizures and refractoriness in benign childhood epilepsy with centrotemporal spikes. Diagnostic delays and nonadherence hindered timely care, which may represent opportunities for improved intervention.
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