Children with Centrotemporal Spikes: Clinical and EEG Characteristics

Song, Hong Ki; Koh, Im Seok

Abstract

BACKGROUND: Centrotemporal spikes (CTS) are the hallmark of the syndrome of benign childhood epilepsy with centrotemporal spikes or Rolandic seizures. However, they also can be encountered in other symptomatic epilepsies or may incidentally be found in non-epileptic children with or without neurological symptoms. We investigated clinical and electroencephalographic characteristics of children with CTS on EEG.
METHODS
A 7 year material of children with CTS on EEG were reviewed. Sixty-eight children were found.
RESULTS
Among them, 55 patients exhibited recurrent rolandic seizures of benign course (so-called benign rolandic epilepsy ; BRE), 9 children suffered from chronic headache without clinical seizure, three patients showed multiple types of seizures or rolandic seizures with some degree of mental retardation, and one child was asymptomatic. In 55 BRE cases, seven children (13%) had a preceding history of febrile convulsions, and a positive family history of epilepsy was found in 9 patients. Generalized spike and wave discharges were observed in 9 patients (16.7%), but none of them experienced clinical absence seizure. In 25 of 29 BRE patients who showed overt lateralized ictal manifestations on history, symptoms were correlated with the main foci of spike discharges. Of the nine children, found to have CTS during evaluation of chronic intermittent or daily headache, the headache was successfully controlled by antiepileptic drugs in two cases.
CONCLUSION
Most children with CTS were compatible to the BRE without any causative lesional factor. However, nonepileptic cases were not uncommon and, though rare, atypical cases were also present in children with CTS on EEG.