Clinical features and comorbidity of self ⁃ limited epilepsy with centrotemporal spikes in children

Abstract

Objective To summarize and analyze the clinical features and comorbidity of attention deficit and hyperactive disorder (ADHD) with self⁃limited epilepsy with centrotemporal spikes (SeLECTS) in children. Methods A total of 89 SeLECTS patients diagnosed in Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from July 2020 to December 2022 were selected. The social demographic data, clinical manifestation, video electroencephalography (VEEG) results, treatment and prognosis of the children were collected. Swanson, Nolan and Pelham⁃Ⅳ Rating Scale (SNAP⁃Ⅳ) was used to assess the comorbidity of ADHD. Results 1) Clinical features: there were 49 males and 40 females in 89 cases of SeLECTS. The age of onset was 3-12 years old, with an average of (7.22 ± 2.04) years old. The main seizure forms were motor seizures of focal origin (36 cases, 40.45%) and focal progression to bilateral tonic ⁃ clonic seizures (46 cases, 51.69%), and 7 cases (7.87%) had both. Main manifestations were unilateral clonic or tonic⁃clonic seizures, drooling, strabismus or upward movement of eyes, abnormal oral movement, and throat vocalization. 2) EEG characteristics: background activity of VEEG of 56 patients was normal, and epileptiform discharge waveforms were mainly sharp (spike) waves, sharp (spike) slow waves complex, spike clusters, and electrical status epilepticus during sleep (ESES). Spike wave index (SWI) during slow wave sleep was 33.00 (19.25, 53.25). 3) Treatment and prognosis: 37 cases (41.57%) were seizure⁃free at least 6 months, and 23 cases (25.84%) were seizure⁃free at least 12 months. 4) Comorbidity: 44 patients (49.44%) had comorbid ADHD. Compared with the non⁃ADHD group, the ADHD group had a younger age of onset (t = 1.621, P = 0.002), a higher SWI (Z = ⁃ 2.134, P = 0.038) and a higher incidence of ESES (χ2 = 4.308, P = 0.038). Conclusions SeLECTS is a self⁃limited epilepsy syndrome in children with characteristic clinical and electroencephalographic features. For children with younger age, higher SWI and ESES, comorbid ADHD should be considered.

Keywords

• epilepsy, rolandic
• attention deficit disorder with hyperactivity
• comorbidity
• electroencephalography