Factors Predicting Poor Response to Initial Therapy in Benign Childhood Epilepsy with Centrotemporal Spikes (BCECTS)

Area of Science:

• Pediatric Neurology
• Epileptology
• Clinical Pediatrics

Background:

• Benign childhood epilepsy with centrotemporal spikes (BCECTS) is the most common pediatric focal epilepsy.
• While typically having positive outcomes, some BCECTS patients experience recurrent seizures requiring antiepileptic drug (AED) treatment.
• Identifying factors for treatment resistance is crucial for optimizing patient care.

Purpose of the Study:

• To identify risk factors associated with a poor response to initial antiepileptic drug (AED) therapy in children diagnosed with BCECTS.
• To differentiate between patients requiring one versus multiple AEDs for seizure control.

Main Methods:

• Retrospective review of 57 BCECTS patients treated with AEDs between 2008 and 2013.
• Patients were categorized into two groups based on the number of AEDs used (1 AED vs. 2 AEDs).
• Clinical characteristics were analyzed to determine independent risk factors for treatment resistance.

Main Results:

• 72% of patients responded to a single AED, while 28% required two AEDs.
• Seizure onset before age 5 (OR: 5.65) and a history of febrile seizures (OR: 4.97) were significant independent risk factors for poor initial AED response.
• EEG findings, brain MRI abnormalities, seizure frequency, and family history did not predict treatment response.

Conclusions:

• Approximately 28% of BCECTS patients exhibit a poor response to initial AED therapy.
• Early seizure onset (prior to age 5) and a history of febrile seizures are critical predictors of inadequate response to initial AEDs in BCECTS.
• These findings aid in predicting treatment outcomes and guiding therapeutic strategies for pediatric epilepsy management.