Is Benign Epilepsy with Centro-temporal Spikes Truly Benign?

Benign epilepsy with centro-temporal spikes (BECTS) is one of the most common pediatric epilepsy syndromes, but it is not widely studied. This may stem from the fact that the condition is assumed to have a relatively benign course. However, a growing body of research suggests that children with BECTS experience subtle cognitive and behavioral problems.

Researchers at Cincinnati Children’s are using neuroimaging techniques to learn more. Their work takes place within the Pediatric Neuroimaging Research Consortium (PNRC), a multidisciplinary group from neurology, radiology, anesthesiology and biostatistics. Consortium Director Jennifer Vannest, PhDrecently led a study to examine the relationship between patterns of centro-temporal spikes (the typical electroencephalography finding in BECTS) and neuropsychological and motor outcomes. Thirty-four patients with new-onset BECTS (who were not taking antiepileptic medication) and 48 typically developing children participated in the study. Researchers studied general intellectual function, language, visuospatial skill, processing speed and fine motor skill in all participants.

“We saw significant negative relationships between rates of left-sided cerebro-temporal spikes and right-hand fine motor scores,” Vannest says. “This suggests that psychomotor and fine motor speed are affected in BECTS, but the extent of affected domains may be more limited than previously suggested, especially in untreated patients early in the course of their epilepsy. We did not find any significant difference between BECTS patients and controls on measures of general intellectual function, or visuospatial or language testing.”

Vannest adds that longitudinal neuropsychological and EEG investigation of these patients would allow for a more complete understanding of their neuropsychological outcomes, the relationship with CTS patterns and risk factors that might indicate a need for intervention.

The study was published in Epilepsia (August 2016). It is just one example of the work taking place at the PNRC. The group uses magnetic resonance imaging and magnetoencephalography to study normal development and clinical conditions that affect the brain, from epilepsy to hydrocephalus to lupus. Researchers collaborate with outside groups such as the National Institute of Child Health and Development, and work with clinical faculty at Cincinnati Children’s to design trials for further study.

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