Prognosis of benign childhood epilepsy with centrotemporal spikes: clinical utility of objective diagnostic criteria

Abstract

Studies about childhood epilepsy with centrotemporal spikes (CECTS), most of them retrospective, include patients with highly heterogeneous features. To investigate the prognostic value of objective diagnostic criteria for CECTS applied at six month of evolution of epilepsy. All patients with one or more unprovoked epileptic seizures (n = 827) were prospectively included. We investigated prognosis and clinical features of five groups of patients defined in accordance with the presence of centrotemporal spikes (CTS) and the following signs: speech arrest or dysarthria; hemifacial tonic or clonic contractions; and prominent sialorrhea. Group A (two or three signs and CTS), group B (one sign and CTS), group C (no sign and CTS), group D (two or three signs without CTS), group E (tonic-clonic generalized seizures and CTS). 52, 12, 12, 22 and 8 cases were classified respectively into groups A, B, C, D and E. Patients of the five groups presented a similar semiology but differences in the probability of attaining a 3-years remission without antiepileptic treatment were observed: group A (98%), group B (92%), group C (90%), group D (77%), group E (100%). The difference between groups A and D was statistically significant. Cases of group A could be considered as well-defined cases of CECTS; cases of groups B, C and E, as probable cases of CECTS, and cases of group D must be excluded from the diagnosis.