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Childhood Absence Epilepsy with Coexisting Centrotemporal Spikes: Frequency, Electroclinical Course and Prognosis
Maria Augusta Montenegro1, Shifteh Sattar2, Mark Nespeca2
1Department of Neurosciences, Rady Children Hospital, University of California San Diego, United States; Yale University, Department of Pediatrics / Neurology.
Epilepsy & Behavior : E&B
|July 18, 2026
Summary
Centrotemporal spikes occur in 9% of childhood absence epilepsy (CAE) patients. Seizures are well-controlled with medication, and outcomes are excellent, even if EEG spikes persist.
Area of Science:
- Neurology
- Pediatric Epilepsy
- Clinical Neurophysiology
Background:
- Childhood absence epilepsy (CAE) is a common epilepsy syndrome in children.
- The presence of centrotemporal spikes in CAE is not well-characterized.
- Understanding this EEG finding's impact on CAE course and prognosis is crucial.
Purpose of the Study:
- To determine the frequency of centrotemporal spikes in CAE patients.
- To evaluate the electroclinical course and prognosis of CAE with centrotemporal spikes.
- To investigate the relationship between EEG findings and treatment response.
Main Methods:
- Retrospective chart review of patients diagnosed with CAE.
- Inclusion criteria: seizure onset < 10 years old.
- Exclusion criteria: developmental delay, abnormal EEG background, atypical seizures, or other epilepsy types.
Main Results:
- 276 patients with CAE were analyzed; 9% exhibited centrotemporal spikes.
- Absence seizures were controlled in all patients treated with antiseizure medication (ASM).
- Generalized epileptiform discharges remitted in 95.5% with ASM, but centrotemporal spikes persisted in 59%.
Conclusions:
- Centrotemporal spikes are an EEG trait in 9% of CAE patients, not indicative of focal seizures.
- Excellent seizure control and prognosis are achieved with ASM, irrespective of persistent centrotemporal spikes.
- Remission of generalized discharges correlates with ASM treatment, highlighting effective management strategies.
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