Spike Localization May Predict Cognitive Outcomes in BECTS
Patients with these EEG characteristics may benefit from early screening and intervention.
While BECTS (benign epilepsy with centrotemporal spikes) is one of the most commonly encountered epileptic syndromes in children and is considered benign, with little known adverse effects on cognitive and behavioral outcomes, it is not well understood how to identify patients who may be at increased risk of developing these deficits, as well as if and how we might address them.
In a study presented at the 2016 Child Neurology Society Annual Meeting, taking place in Vancouver, British Columbia, October 26-29, 2016, researchers led by Rose Gelineau-Morel, MD, from the Cincinnati Children's Hospital Medical Center, conducted 24-hour EEGs in 29 patients with a recent diagnosis of BECTS in order to evaluate whether spike localizations correlate with neurobehavioral outcomes.
Patients with spike localization–defined as “lead(s) with a phase reversal in the AP bipolar montage of the EEG and spread defined within the same montage as any lead with a visible deflection from the background at the time of the spike”–that extended beyond the centrotemporal regions (n=9) showed significantly lower scores for language testing compared with patients whose spikes were localized to only centrotemporal regions (n=20). Measures of language outcomes included the CELF core (86.75 vs 99.58, P =.05), CTOPP phonological awareness (90.78 vs 102.17, P =.01), Woodcock Johnson letter-word (99.33 vs 108.28, P =.03), and NEPSY verbal fluency (7.17 vs 9.64, P =.05).
Notably, patients who showed greater spread in the left hemisphere demonstrated a trend toward poorer language outcomes, as well (NEPSY semantic, r2= .11, P =.08; CTOPP naming, r2= .14, P =.06).
Due to the results of their study, the researchers suggested that patients with these EEG characteristics may benefit from early screening and intervention in order to identify and address cognitive deficits.
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Gelineau-Morel R, Tenney J, Maloney T, Vannest J. EEG spike localization in BECTS: correlates with neuropsychological outcomes. Presented at: 2016 Child Neurology Society Annual Meeting. October 26-29, 2016; Vancouver, BC. Abstract 60.