A follow-up study of healthy children with epileptiform EEG discharges

Abstract

Fifty-two healthy elementary schoolchildren with epileptiform EEGs who were not taking anticonvulsants were followed for an average period of 3 years and 3 months. Thirty-seven had centrotemporal spikes, three had occipital spikes, one had frontal spikes, nine had generalized spike-and-wave complexes, and two had a combination of multiple spike-and-wave complexes and focal spikes. Disappearance of epileptiform discharges was observed in 65% on waking EEGs and in 45% on sleep EEGs. After 5 years, the rate of disappearance was over 80% in waking and sleep EEGs. This study confirms that most epileptiform discharges in healthy children disappear spontaneously during childhood and that age-related development and disappearance occur in healthy children who would otherwise never be subjected to EEG examination. Epileptic seizures occurred in three cases (6%). This low percentage is not considered to be an indication for treating children with epileptiform discharges with anticonvulsants. However, the risk for seizure development may be higher than in the general population. According to the literature, children with multiple spike-wave complexes have a greater tendency to develop seizures. One girl with multiple spike-wave complexes and focal spikes developed generalized tonic-clonic convulsions. Two boys with centrotemporal spikes developed benign childhood epilepsy with centrotemporal spikes (BCECS). This study confirms that some (5%) of healthy children with centrotemporal spikes, the most common epileptiform pattern in healthy children, develop BCECS.