Childhood absence epilepsy and benign epilepsy with centro-temporal spikes: a narrative review analysis

Background:Recent studies have shown a possible coexistence of absence seizures with other forms of epilepsy.The purpose of this study was to ascertain the possible contemporary or subsequent presence of childhood absence epilepsy (CAE) and benign epilepsy with centro-temporal spikes (BECTS) in pediatric epileptic patients.Data sources:A PubMed systematic search indexed for MEDLINE,PubMed and EMBASE was undertaken to identify studies in children including articles written between 1996 and 2015.Retrospective studies,meta-analysis and case reports were included.The list of references of all the relevant articles was also studied.The date of our last search was December 2015.Results:Review of the literature revealed 19 cases,8 females and 11 males,reporting a consecutive or contemporary coexistence of CAE and BECTS within the same patients.Patient's age ranged between 4 and 12 years.Three out of 19 patients presented concomitant features of both syndromes,whereas 16 patients experienced the two syndromes at different times.Conclusions:BECTS and CAE may be pathophysiologically related,and the two epileptic phenotypes may indicate a neurobiological continuum.Further studies are needed to elucidate a probable genetic or functional link between partial and primarily generalized electro-clinical patterns in idiopathic childhood epilepsies.

Consecutive occurrence of benign epilepsy with centro-temporal spike and childhood absence epilepsy: true coexistence or atypical evolution?

We read with great interest the recent review of benign epilepsy with centro-temporal spikes (BECTS) and child-hood absence epilepsy (CAE) by Verrotti et al. (1)BECTS and CAE are the most common epilepsy syndromes in childhood and share certain clinical features: similar age at onset, overall good prognosis, and genetic predispo-sition. Several studies have reported the coexistence of the two syndromes, and recently, Verrotti et al. analyzed 19 cases reported to have clinical features of CAE and BECTS. Among the total 19 cases, three cases had fea-tures of both syndromes contemporarily;three cases expe-rienced absence seizures initially followed by BECTS;and the other 13 cases experienced BECTS at onset and had absence seizures later.

Oxcarbazepine monotherapy in children with benign epilepsy with centrotemporal spikes improves quality of life

Background:Benign epilepsy with centrotemporal spikes(BECTS)is the most common type of childhood idiopathic focal epilepsy.BECTS is associated with pervasive cognitive deficits and behavior problems.While seizures can be easily controlled,it is crucial to select anti-epileptic drugs that do not impair cognition,do not cause psychosocial effects,and improve the quality of life.Previous studies showed effects of oxcarbazepine(OXC)monotherapy on the cognitive and psychosocial profiles of patients with BECTS.Here,we studied the effects of OXC monotherapy on the neuropsychologic profiles and quality of life in patients with BECTS in China.Methods:Thirty-one patients aged 6 to 12 years newly diagnosed with BECTS were recruited.A psychometric assessment was performed before and during the follow-up of OXC monotherapy with Cognitive Computerized Task Battery,Depression SelfRating Scale for children,Screen for Child Anxiety Related Emotional Disorders,and Quality of Life in Epilepsy-31(QOLIE-31).The results of the assessments were compared to explore the effect of OXC monotherapy in patients with BECTS.Results:Thirty children with BECTS completed the study.Five of ten cognitive test scores improved after treatment via OXC monotherapy,including visual tracing(F=14.480,P<0.001),paired associated learning(language)(F=6.292,P<0.001),paired associated learning(number)(F=9.721,P<0.05),word semantic(F=6.003,P<0.05),and simple subtraction(F=6.229,P<0.05).Of the neuropsychology data concerning the quality of life,statistically significant improvements were observed in emotion(F=4.946,P<0.05),QOLIE-social(F=5.912,P<0.05),and QOLIE-total(F=14.161,P<0.001).Conclusions:OXC is safe and does not impair neuropsychologic functions,with no obvious mood burden on children with BECTS.Most importantly,OXC has positive impacts on children’s perception of quality of life,especially in terms of happiness and life satisfaction.

伴中央颞区棘波的良性癫幼儿的行为特点

目的探讨伴中央颞区棘波的良性癫(BECTS)儿童在幼儿期的行为特点。方法BECTS患儿82例。男51例,女31例;年龄2.5～3.0(2.65±2.31)岁。均未服用过抗癫药物,经格塞尔智能发育量表评定后排除智能低下,在发作15d后进行行为评定。健康对照组82例。男53例,女29例;年龄2.5～3.0(2.6±0.4)岁。BECTS组与健康对照组性别及年龄差异无统计学意义。采用《2～3岁儿童Achenbach行为量表(CBCL)》包括社会退缩、抑郁、睡眠问题、躯体诉述、攻击行为和破坏行为等6个行为因子和《婴儿-初中学生社会生活能力量表》包括独立生活能力、活动能力、作业操作、沟通能力、集体活动和自我管理等6个区域,对二组儿童的行为特点和社会适应行为进行评定,并对二组儿童各行为因子及社会生活能力评分进行比较。结果BECTS组患儿行为特点总分高于健康对照组,差异有统计学意义,其中抑郁、睡眠问题、攻击行为和破坏行为问题因子得分高于健康对照组,二组间差异有统计学意义,而社会退缩和躯体诉述方面无显著性差异。二组儿童社会生活能力构成比无显著性差异。结论BECTS儿童在幼儿期存在不同程度的行为障碍,暂时在社会生活能力方面未显现其功能的缺陷。