Childhood Absence Epilepsy with Coexisting Centrotemporal Spikes: Frequency, Electroclinical Course and Prognosis.
TL;DR
Remission of the generalized epileptiform discharges correlates with ASM treatment and seizure outcome is excellent, despite persistence of centrotemporal spikes, suggesting that it reflects an EEG trait.
Abstract
Objective
The objective of this study was to evaluate the frequency, electroclinical course and prognosis of patients with CAE that also present with centrotemporal spikes.
Methods
This was a retrospective study based on chart review. Patients with diagnosis of CAE and seizure onset < 10 years-old were included. Patients with developmental delay, abnormal EEG background, atypical absence, generalized tonic-clonic, myoclonic or eyelid myoclonic seizures were excluded.
Results
276 patients with CAE were included; 25 (9%) had at least one EEG showing centrotemporal spikes. Age of absence seizure onset ranged from 3 to 10 years-old (mean = 6 years-old). Absence seizures were controlled in all patients treated with antiseizure medication (ASM). CAE evolved to other type of idiopathic generalized epilepsy in four (16%) patients. No patient had generalized tonic-clonic seizures, except those with evolution to other type of idiopathic generalized epilepsy. No patient had focal seizures. Remission of the generalized epileptiform discharges correlated with ASM treatment in 95.5% of the patients, whereas centrotemporal epileptiform discharges persisted in 59%. Follow-up ranged from 1 to 16 years (mean = 6 years; median = 6 years).
Conclusion
Centrotemporal spikes were identified in 9% of patients with CAE. Focal seizures were not seen, suggesting that it reflects an EEG trait. Remission of the generalized epileptiform discharges correlates with ASM treatment and seizure outcome is excellent, despite persistence of centrotemporal spikes.