Abstracts

Rationale: Benign Epilepsy with Centrotemporal Spikes (BECTS) is characterized by infrequent simple partial and/or secondarily generalized seizures but frequent centrotemporal spikes (CTS) on EEG which vary in frequency and lateralization across patients. Previous studies suggest BECTS patients may have subtle cognitive deficits, particularly in language function, and we hypothesized that the frequency and lateralization of CTS would be related to language outcomes. Our aim was to use EEG and cognitive testing to examine language ability in BECTS patients compared to healthy controls and how differences may relate to CTS frequency and lateralization. Methods: 19 patients with BECTS (age 5-11, 7F) and 19 age- and gender- matched healthy children participated. No BECTS patients were taking anti-epileptic medication during their initial study visit. CTS profiles of BECTS patients were determined by epileptologists, visually marking CTS in at least 1 hour awake and at least 20 minutes of EEG during sleep. Four BECTS patients showed greater left sided CTS activity, 4 had bilateral independent CTS, 1 showed bilateral synchronous CTS and 10 greater right-sided CTS activity. Language skill was assessed in all participants using the Clinical Evaluation of Language Fundamentals (CELF, Semel et al., 2003). One-year follow-up EEG and CELF was also collected in 9 BECTS patients (age 6-12, 5F); at one-year follow up, 3 patients were taking Levetiracetam. Results: CELF standard scores for BECTS patients (mean 95.5) were significantly lower than controls (mean 104.0) [t(36)=2.04, p<.05]. In BECTS patients, a significant negative correlation (r²=.23, p<0.05) was found between CELF scores and the frequency of left-sided CTS during sleep (Figure 1). One-year follow-up testing in 9 patients revealed that 4 BECTS patients no longer had CTS; mean change in CELF score was +5.33 points (SD 11.12). Only one patient showed a change in CELF score at follow-up greater than 15 points; this patient also had resolution of CTS (not on anti-epileptic medication). Three patients were taking Levetiracetam at one-year follow-up; one of these patients showed resolution of CTS. Conclusions: Lower language function in BECTS is related to the presence of frequent left-sided CTS during sleep. In preliminary follow-up data, the relationship between possible improvements in language skill and resolution of CTS is less clear.