Abstracts

Rationale: Benign focal epilepsy with centro-temporal spikes (BECTS) is the most common childhood epilepsy syndrome. Children with BECTS frequently present with learning and language difficulties (Epilepsia. 2006; 47 Suppl 2:71-5). The objective of our study was to determine the frequency and clinical presentation of comorbidities in children with BECTS including cognitive, language and psychiatric disorders. Methods: Consecutive pediatric routine EEGs from 1995-2004 were reviewed for patients with benign focal epileptiform discharges. The charts of these patients were then reviewed for BECTS as defined as (a) seizures consisting of typical brief hemi-facial seizures associated with speech arrest, drooling, and preservation of consciousness or with gurgling/grunting noises with loss of consciousness and terminating in vomiting or (b) nocturnal secondarily generalized seizures. Data was collected on general demographics and neurologic, behavioral and psychiatric disorders. Descriptive data and Fisher’s exact test were used for analysis. Results: Seizures consistent with BECTS semiology were seen in 117 children, including 51 girls and 66 boys (F: M = 0.77). Mean age at initial diagnosis of EEG abnormality was 6.8 years (range 1 to 13 years). The mean age at diagnosis in girls was 6.2 years while in boys was 7.0 years. Co-existing psychiatric diagnoses were seen in 11 children (9.4%) with the incidence being significantly higher among boys (9) than girls (2) (p<0.05). The boys had a higher incidence of anxiety (5), schizophrenia (2), obsessive-compulsive disorder (1), and depression (1). Only 2 girls had co-existing psychiatric illnesses (major depression and minor depressive disorder). Attention deficit-hyperactivity disorder (ADHD) was seen in 13 children (11%), including 5 girls and 8 boys. The average age of patients with ADHD was 6.1 years (5.8 girls, 6.3 boys). Developmental delay (pervasive developmental disorder, language disorder, and autism) was found in 12 children (10.2%). Two girls had isolated language delay. Of the 6 boys with developmental delay, only one had isolated language delay. Three children had autism (1 girl, 2 boys) and one had Asperger’s syndrome. Tics were present in 4 boys and 2 girls. Conclusions: Our review of 117 children found a higher incidence of ADHD (11%), developmental delay (10%), and psychiatric illnesses (9.4%) among children with BECTS compared to the general population of school aged children averaging 2-7%. Developmental disorders and psychiatric disorders were more common among boys than girls. Timely screening for associated comorbidities in pediatric patients with BECTS along with management of epilepsy may improve clinical outcome and management.