Cognitive and behavioral problems in children with centrotemporal spikes

• Published in: Pediatric neurology Vol. 23; no. 5; pp. 391 - 395
• Main Authors: Yung, Ada W.Y, Park, Yong D, Cohen, Morris J, Garrison, Tara N
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2000; Elsevier
• Subjects: Adolescent; Behavioral Symptoms - etiology; Behavioral Symptoms - psychology; Biological and medical sciences; Child; Child, Preschool; Cognition Disorders - etiology; Cognition Disorders - psychology; Electroencephalography; Epilepsy, Rolandic - complications; Epilepsy, Rolandic - psychology; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Learning Disorders - etiology; Learning Disorders - psychology; Male; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Human; Nervous system diseases; Cognitive disorder; Central nervous system disease; Complication; Rolandic epilepsy; Child; Cerebral disorder; Behavioral disorder
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/S0887-8994(00)00220-4

Atypical features in benign epilepsy of childhood with centrotemporal spikes (BECTS) are not uncommon. There are children with BECTS who do not have a benign outcome in terms of neuropsychologic functioning. BECTS have been linked with Landau-Kleffner syndrome (LKS) and continuous spikes and waves during slow sleep (CSWS). At the Medical College of Georgia from January 1988 to June 1999, 78 children, ages 2-16 years, were identified to have electroencephalogram evidence of centrotemporal spikes. Their medical records were reviewed for developmental history, behavioral problems, and school performance. Children with structural lesions/other epileptic syndromes were excluded. Fifty-six demonstrated a history of clinical seizures compatible with BECTS and 22 demonstrated centrotemporal spikes without clinical seizures. Among all children with centrotemporal spikes, 9% (n = 7) were diagnosed with mild intellectual disability (intelligence quotient < 70), 10% (n = 8) with borderline functioning, 31% (n = 24) with behavioral problems, and 17% (n = 13) with specific learning disabilities. Three children with BECTS experienced language delay and regression. Seizure control for BECTS usually is achieved without much difficulty, with excellent long-term prognosis. However, the data presented indicate that a large number of BECTS patients exhibit learning or behavior problems that require intervention. A small number may demonstrate language outcome similar to children with LKS and CSWS.