Childhood Epilepsy with Centrotemporal Spikes

Benign Childhood Epilepsy with Centrotemporal Spikes is the most common epilepsy syndrome in childhood (10-25% of childhood epilepsies).

What is it?

Centrotemporal spikes refers to the part of the brain where the focal seizures associated with this syndrome occur, which controls movement. ‘Benign’ refers to the fact that children usually develop normally and that seizures usually cease spontaneously by puberty. Often medication is not prescribed due to the low frequency of seizures (10-20% of children only have one seizure.) The syndrome was formerly known as Benign Rolandic Epilepsy, Rolandic seizures, BECT or Sylvan Fissure Epilepsy.

Symptoms

The seizures have a focal onset usually beginning in the face, mouth and tongue as twitching, numbness or a tingling sensation and the child usually retains awareness during some or all of the seizure.

Other symptoms may include:

  •          a tonic contraction of one side of the face and/or jerks of the cheeks and eyelids 
  •          guttural sounds
  •          movements of the mouth
  •          contraction of the jaw
  •          feelings of suffocation
  •          profuse salivation
  •          sensations inside or about the mouth
  •          clonic jerks of an arm (sometimes)
  •          muscle weakness on one side of the body
  •          speech disturbance

The seizures can generalise to tonic-clonic seizures; in some cases, the first seizure is a generalised seizure with the focal phase not witnessed. The majority of seizures (70-80%) are nocturnal and occur during sleep. Onset is usually mid-late childhood with peak age from 7-9 years and a slightly greater incidence in boys. About 30% of children will have a family history of epilepsy and it is thought to have a genetic basis.