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Self-Limited Epilepsy with Centrotemporal Spikes in Younger Ages: Worse but Real!
Furkan Donbaloğlu1, Mehpare Sarı Yanartaş, Chakan Tsakir
1Faculty of Medicine, Department of Pediatric Neurology, Akdeniz University, Antalya, Turkey.
Insights
Children with self-limited epilepsy with centrotemporal spikes (SeLECTS) diagnosed before age 5 require more medications and longer treatment for seizure control and EEG normalization. These younger SeLECTS patients also experienced longer seizure control durations.
Area of Science:
- Pediatric Neurology
- Epileptology
- Clinical Neurophysiology
Background:
- Self-limited epilepsy with centrotemporal spikes (SeLECTS) is a common childhood epilepsy syndrome.
- Understanding age-related differences in SeLECTS clinical course is crucial for management.
Purpose of the Study:
- To compare clinical features and outcomes of SeLECTS in pediatric patients based on age at diagnosis.
- To identify potential age-specific management strategies for SeLECTS.
Main Methods:
- Retrospective analysis of 198 pediatric patients diagnosed with SeLECTS between 2012 and 2023.
- Patients were divided into two groups: under 5 years and over 5 years at diagnosis.
- Clinical data, EEG patterns, and treatment responses were analyzed.
Main Results:
- Younger children (under 5) required significantly more antiepileptic drugs (P=0.041) and polytherapy (P=0.02).
- Seizure control (P<0.001) and EEG normalization (P<0.001) took longer in the under-5 group.
- Electrical status epilepticus in slow-wave sleep occurred only in patients over 5 years old.
Conclusions:
- Pediatric SeLECTS patients diagnosed under age 5 face prolonged seizure control and EEG recovery periods.
- Younger SeLECTS patients necessitate more intensive antiepileptic treatment regimens.
- Age at diagnosis is a significant factor influencing SeLECTS prognosis and management intensity.
Background And Objective:
To compare the clinical features and consequences of self-limited epilepsy with centrotemporal spikes (SeLECTS) between two age groups by the consideration of a pediatric cohort.
Methods:
Patient data and follow-up observations of children with SeLECTS were documented between 2012 and 2023. Clinical profiles, electrocephalogram (EEG) patterns, and treatment details of the children diagnosed with SeLECTS were retrospectively examined and analyzed in two separate groups based on age at diagnosis.
Results:
A group of 198 patients with SeLECTS was included. The study group was divided into two subgroups as the group under age 5 (n = 54) and the group over age 5 (n = 144). The number of antiepileptics needed for seizure control ( P = 0.041) and the need for more than one antiepileptic ( P = 0.02) were found to be higher, with statistical significance, in the group younger than 5 years old. Moreover, the duration of control of seizures ( P < 0.001) and recovery of EEG was longer ( P < 0.001) in the group younger than 5 years. Electrical status epilepticus in slow-wave sleep emerged in four patients, and findings revealed that all of these patients were in the group over the age of 5.
Conclusions:
SeLECTS patients diagnosed under the age of 5 experience a longer duration to achieve seizure control and EEG normalization. Additionally, these patients often require a greater number of antiepileptic medications for effective seizure management.
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