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Spike persistence and normalization in benign epilepsy with centrotemporal spikes - Implications for management.

Hunmin Kim1, Soo Yeon Kim2, Byung Chan Lim2

  • 1Department of Pediatrics, Seoul National University Bundang Hospital, Bundang, Republic of Korea; Pediatric Regional Epilepsy Center, Children's Hospital of Philadelphia, Philadelphia, PA, United States.

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In benign epilepsy with centrotemporal spikes (BECTS), early seizure onset predicts longer spike persistence. Spikes persisting at medication withdrawal do not increase seizure recurrence risk.

Keywords:
BECTSElectroencephalography (EEG)EpilepsySpike

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Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Clinical Neurophysiology

Background:

  • Benign epilepsy with centrotemporal spikes (BECTS) is a common childhood epilepsy syndrome.
  • Understanding spike normalization patterns is crucial for managing BECTS and predicting outcomes.

Purpose of the Study:

  • Determine the timeline for electroencephalogram (EEG) spike normalization in BECTS patients.
  • Investigate correlations between seizure onset age, spike normalization, spike duration, and treatment.
  • Assess seizure outcomes based on the presence of spikes during antiepileptic drug (AED) tapering.

Main Methods:

  • Retrospective analysis of 134 BECTS patients' clinical and serial EEG data.
  • Assessment of age at seizure onset and spike normalization, and duration of spike persistence.
  • Comparison of seizure and EEG outcomes in patients with and without spikes at AED tapering.

Main Results:

  • Mean age at seizure onset was 7.5 years; mean age at spike normalization was 11.9 years.
  • Younger seizure onset correlated with longer spike persistence (r = -0.41, p < 0.001).
  • AED treatment did not shorten spike persistence duration (4.1 years with treatment vs. 2.9 years without).
  • No seizure recurrences were observed after AED discontinuation, irrespective of spike presence at tapering.

Conclusions:

  • Early-onset BECTS is associated with prolonged spike persistence.
  • Antiepileptic drug treatment does not appear to accelerate spike normalization in BECTS.
  • The presence of interictal spikes during AED tapering does not predict seizure recurrence in BECTS.