Prevalence and Functional Significance of 14 and 6 Hz Positive Spikes in Self-Limited Epilepsy With Centrotemporal
Margil Ranpariya1, Natasha Qutab1,2, Jonathan Hanson1,2
1Department of Neurology, University at Buffalo, Buffalo, New York, USA.
Insights
14 and 6 Hz positive spikes (PS) are highly prevalent in children with Self-limited Epilepsy with Centrotemporal spikes (SeLECTs). These spikes may indicate developmental issues in brain networks, challenging their benign classification.
Area of Science:
- Pediatric Neurology
- Neurophysiology
- Epileptology
Background:
- Self-limited Epilepsy with Centrotemporal spikes (SeLECTs) is a common childhood epilepsy syndrome.
- 14 and 6 Hz positive spikes (PS) are EEG findings with debated clinical significance.
Purpose of the Study:
- To determine the prevalence of 14 and 6 Hz PS in children with SeLECTs.
- To explore the functional significance and neurophysiological mechanisms of PS in SeLECTs.
- To investigate the correlation between PS and clinical features in SeLECTs.
Main Methods:
- Video-EEG monitoring of 52 pediatric SeLECTs patients and 52 controls.
- EEG analysis by blinded epileptologists to identify 14 and 6 Hz PS.
- Comparison of PS prevalence and lateralization with centrotemporal spikes.
Main Results:
- 14 and 6 Hz PS were detected in 80.8% of SeLECTs patients, versus 0% in controls (P < 0.001).
- No significant lateralization correlation was found between PS and centrotemporal spikes (P = 0.651).
- Only 28.6% of PS cases showed lateralization matching centrotemporal spikes.
Conclusions:
- 14 and 6 Hz PS are significantly more prevalent in children with SeLECTs.
- PS may reflect developmental immaturity in thalamocortical and corticolimbic networks, suggesting heightened cortical excitability.
- Findings challenge the view of PS as benign, supporting their role in thalamocortical dysregulation in childhood epilepsy.
Purpose:
To investigate the prevalence and functional significance of 14 and 6 Hz positive spikes (PS) in children with Self-limited Epilepsy with Centrotemporal spikes and explore their potential correlation with clinical features and neurophysiological mechanisms.
Methods:
Our study included 52 pediatric Self-limited Epilepsy with Centrotemporal spikes patients and 52 age-matched controls who underwent ≥48-hour video-EEG monitoring in the epilepsy monitoring unit at Oishei Children's Hospital from 2016 to 2024. EEGs were reviewed by blinded epileptologists to identify the presence, localization, and lateralization of 14 and 6 Hz PS.
Results:
Fourteen and 6 Hz PS were detected in 80.8% ( n = 42) of SeLECTs patients versus 0% of controls ( P < 0.001). No significant lateralization correlation was found between PS and centrotemporal spikes ( P = 0.651); only 28.6% of PS cases matched centrotemporal spikes lateralization.
Conclusions:
This study demonstrates a significantly higher prevalence of 14 and 6 Hz PS in children with Self-limited Epilepsy with Centro-temporal spikes. Their high prevalence and similar age-dependent expression and sleep-related activation suggest that PS may reflect developmental immaturity in thalamocortical networks, immature corticolimbic circuits, and heightened cortical excitability. These findings challenge the traditional view of PS as benign and support their potential role in thalamocortical dysregulation in self-limited childhood epilepsies.
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