Childhood Absence Epilepsy Associated With Concomitant Centrotemporal Spikes

Area of Science:

• Pediatric Neurology
• Epileptology
• Clinical Neurophysiology

Background:

• Childhood absence epilepsy (CAE) is characterized by 3Hz spike-wave complexes.
• Benign epilepsy with centrotemporal spikes (BECTS) presents with centrotemporal spikes.
• The co-occurrence of both electrographic patterns is exceptionally rare in pediatric epilepsy.

Purpose of the Study:

• To investigate the electrographic and clinical characteristics of pediatric patients with coexisting CAE and BECTS.
• To analyze the diagnostic and therapeutic challenges posed by overlapping epilepsy syndromes.

Main Methods:

• Retrospective analysis of pediatric epilepsy cases over a five-year period (2014-2018).
• Identification of patients with overlapping EEG findings of CAE and BECTS.
• Detailed analysis of clinical presentation, EEG patterns, treatment outcomes, and comorbidities.

Main Results:

• Nine pediatric patients (ages 5-14) exhibited overlapping EEG findings of CAE and BECTS.
• Absence seizures were the primary clinical presentation.
• Six patients showed concomitant EEG features, while three had sequential patterns.
• Valproate was effective as first-line treatment, but some required add-on therapy.
• Poor school performance and comorbidities like ADHD were noted in several patients.

Conclusions:

• The coexistence of CAE and BECTS, though rare, can occur in pediatric epilepsy.
• Overlap is primarily observed in electrographic features, with or without concurrent clinical manifestations.
• Recognition of these combined syndromes is crucial for appropriate management and addressing associated challenges.