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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
PubMed

Insights

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.
Abstract

Keywords:
Centrotemporal spikesChildhood absence epilepsyEEG

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