Benign childhood epilepsy with centrotemporal spikes and hippocampal atrophy

A boy without significant family or personal history had three consecutive nocturnal seizures at 1-month intervals at age 10 years, all simple focal s eizures with motor and sensory symptoms, the last with secondary generaliza tion. Waking and napping EEG showed focal sharp changes typical of benign e pilepsy with centrotemporal spikes (BECTS). A magnetic resonance imaging do cumented a marked right hippocampal atrophy (HA). After valproic acid (VPA) therapy, there were no more seizures, and there were fewer EEG changes. An EEG performed in the younger, fully asymptomatic 8-year-old sister documen ted unilateral right focal sharp waves. This case shows that HA, as well as other central nervous system lesions, can be found fortuitously in patient s with BECTS.