Electroclinical biomarkers predicting EEG normalization and polytherapy needs in self-limited epilepsy with
Eun Song Song1, Sanghoon Lee1, Young Ok Kim1
1Department of Pediatrics, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Pediatrics, Chonnam University Children's Hospital, Gwangju, Republic of Korea.
Insights
EEG normalization in self-limited epilepsy with centrotemporal spikes (SeLECTS) occurs around age 11.4 years. Seizure onset age and discharge laterality predict EEG remission, while clinical factors like ADHD influence polytherapy needs.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Neurophysiology
Background:
- Self-limited epilepsy with centrotemporal spikes (SeLECTS) is a common childhood epilepsy.
- Predictors for EEG normalization and polytherapy requirements in SeLECTS remain unclear.
Purpose of the Study:
- To determine the timing of EEG remission in SeLECTS.
- To identify electroclinical biomarkers associated with EEG normalization and polytherapy needs.
Main Methods:
- Retrospective analysis of 153 pediatric patients with SeLECTS and normalized sleep EEGs.
- Data collected from Chonnam National University Hospital between 2010 and 2025.
Main Results:
- Median age for EEG normalization was 11.4 years, with a median interval of 45.9 months.
- Earlier seizure onset and unilateral discharges were linked to younger EEG normalization.
- Polytherapy was more common in patients with early childhood onset, Todd's paralysis, daytime seizures, or ADHD.
Conclusions:
- EEG remission in SeLECTS is associated with seizure onset age and dipole findings.
- Clinical factors, rather than electrical biomarkers, are more influential in determining the need for polytherapy.
Background:
Self-limited epilepsy with centrotemporal spikes (SeLECTS) is a well-known self-limited focal epilepsy in children. While centrotemporal discharges remit with age, the timing and biomarkers predicting EEG normalization and polytherapy needs are not well established.
Purpose:
This study aimed to identify the timing of EEG remission and electroclinical biomarkers influencing remission and polytherapy needs in SeLECTS.
Methods:
We retrospectively reviewed 153 of 401 patients (<18 years) with SeLECTS whose sleep EEGs normalized (2010-2025, Chonnam National University Hospital).
Results:
The median age at sleep EEG normalization was 11.4 years (IQR, 10.1-13.2), with a median interval of 45.9 months (IQR, 27.0-66.8). Seizure-onset age correlated positively with EEG normalization age (R = 0.457) and negatively with the interval to normalization (R = -0.508; P < 0.001). EEG normalized younger in patients with unilateral (10.9 vs. 12.0 years, P = 0.002) or right-dominant discharges (11.2 vs. 13.0 years, P = 0.023). The EEG normalization interval increased with a longer gap between the first and second seizures (R = 0.279; P = 0.001). It was shorter in unilateral discharges (28.1 vs. 53.9 months; P < 0.001), and longer in the polytherapy group (57.3 vs. 43.5 months; P = 0.006). Polytherapy was more frequent in early childhood (50.5 % vs. 21.0 %; P = 0.005), and in patients with Todd's paralysis (71.4 % vs. 26.0 %; P = 0.019), daytime seizures (64.7 % vs. 23.5 %; P < 0.001), or attention deficit/hyperactivity disorder (ADHD; 66.7 % vs. 25.7 %; P = 0.015).
Conclusion:
EEG remission is associated with seizure-onset age and dipole findings, whereas the need for polytherapy is influenced more by atypical clinical than electrical biomarkers.
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