Cognitive and behavioral problems in children with centrotemporal spikes

Atypical features in benign epilepsy of childhood with centrotemporal spike s (BECTS) are not uncommon. There are children with BECTS who do not have a benign outcome in terms of neuropsychologic functioning. BECTS have been l inked with Landau-Kleffner syndrome (LKS) and continuous spikes and waves d uring slow sleep (CSWS), At the Medical College of Georgia from January 198 8 to June 1999, 78 children, ages 2-16 years, were identified to have elect roencephalogram evidence of centrotemporal spikes. Their medical records we re reviewed for developmental history, behavioral problems, and school perf ormance. Children with structural lesions/other epileptic syndromes were ex cluded. Fifty-six demonstrated a history of clinical seizures compatible wi th BECTS and 22 demonstrated centrotemporal spikes without clinical seizure s. Among all children with centrotemporal spikes, 9% (n = 7) were diagnosed with mild intellectual disability (intelligence quotient < 70), 10% (n = 8 ) with borderline functioning, 31% (n = 24) with behavioral problems, and 1 7% (n = 13) with specific learning disabilities. Three children with BECTS experienced language delay and regression, Seizure control for BECTS usuall y is achieved without much difficulty, with excellent long-term prognosis. However, the data presented indicate that a large number of BECTS patients exhibit learning or behavior problems that require intervention. A small nu mber may demonstrate language outcome similar to children with LKS and CSWS , (C) 2000 by Elsevier Science Inc. All rights reserved.