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Epidemiology of self-limited epilepsy with centrotemporal spikes (SeLECTS): A population study using primary care
Arron S Lacey1, Carys B Jones1, Seung Gwan Ryoo1
1Swansea University Medical School, Swansea University, Swansea, UK.
Insights
This study found a lower incidence of self-limited epilepsy with centrotemporal spikes (SeLECTS) than previously reported, with no change over time. Screening for neurodevelopmental issues in children with SeLECTS is recommended.
Area of Science:
- Pediatric Neurology
- Epileptology
- Public Health
Background:
- Limited epidemiological data exists for self-limited epilepsy with centrotemporal spikes (SeLECTS).
- Understanding SeLECTS incidence, socioeconomic associations, and comorbidities is crucial for effective public health strategies.
- Previous research has not fully elucidated the epidemiology of SeLECTS in pediatric populations.
Purpose of the Study:
- To determine the incidence of SeLECTS in children.
- To investigate the association between SeLECTS incidence and socioeconomic deprivation.
- To assess the prevalence of neurodevelopmental comorbidities in children with SeLECTS.
Main Methods:
- Retrospective cohort study utilizing linked primary care and demographic data from Wales (2004-2017).
- Identification of SeLECTS cases using primary care diagnosis codes in children aged 0-16 years.
- Mixed effects Poisson regression analysis to assess temporal trends and socioeconomic associations.
Main Results:
- A total of 186 (3%) of 6,732 children with epilepsy were diagnosed with SeLECTS.
- The crude incidence of SeLECTS in 2017 was 1.1/100,000/year, lower than previously reported.
- 18% of children with SeLECTS had neurodevelopmental disorders or school problems, and half received antiseizure medication.
Conclusions:
- The incidence of SeLECTS may be lower than previously estimated, potentially due to under-recording.
- No significant association was found between SeLECTS incidence and socioeconomic deprivation, though sample size limitations exist.
- Routine screening for neurodevelopmental and learning comorbidities is recommended for children diagnosed with SeLECTS.
Background And Objective:
Information on self-limited epilepsy with centrotemporal spikes (SeLECTS) epidemiology is limited. We aimed to determine the incidence of SeLECTS in children, its association with socioeconomic deprivation and the prevalence of neurodevelopmental comorbidities.
Method:
We performed a retrospective cohort study (2004-2017) using anonymised, linked, routinely collected, primary care and demographic data for children in Wales. We used primary care diagnosis codes to identify children (aged 0-16 years) with SeLECTS and other epilepsies and to record antiseizure medication (ASM) prescriptions and neurodevelopmental comorbidities. We used a mixed effects Poisson regression model to determine temporal trends of SeLECTS incidence and its association with socioeconomic deprivation.
Results:
We identified 6,732 children with epilepsy, 186 (3%) with SeLECTS. In 2017, epilepsy and SeLECTS prevalence was 0.55% and 0.02% respectively with corresponding crude incidence of 51.2/100,000/year and 1.1/100,000/year. The incidence of epilepsy in children decreased with decreasing deprivation with an adjusted incidence rate ratio (AIRR) of 0.72 (95% CI 0.64-0.82) in the least deprived compared with the most deprived quintile. The corresponding AIRR for children with SeLECTS was 1.35 (95% CI 0.46-1.99). 34% of children with epilepsy, 18% of children with SeLECTS and 3% of all children in Wales had a neurodevelopmental disorder and or school problems. Half of children with SeLECTS were treated with ASM.
Conclusions:
We identified a lower than previously reported incidence of SeLECTS, which may be due to under-recording of SeLECTS. There was no change in the incidence of SeLECTS over time, whilst the incidence of childhood epilepsy overall was decreasing. There was no significant association between incidence of SeLECTS and deprivation but the modest sample size needs to be considered. Children with SeLECTS should be screened for neurodevelopmental and or learning comorbidities. Treatment for SeLECTS remains debatable.
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