Brain Dev. 2025 Sep 25;47(5):104449. doi: 10.1016/j.braindev.2025.104449. Online ahead of print.
ABSTRACT
BACKGROUND: Self-limited epilepsy with centrotemporal spikes (SeLECTS) is a well-known self-limited focal epilepsy in children. While centrotemporal discharges remit with age, the timing and biomarkers predicting EEG normalization and polytherapy needs are not well established.
PURPOSE: This study aimed to identify the timing of EEG remission and electroclinical biomarkers influencing remission and polytherapy needs in SeLECTS.
METHODS: We retrospectively reviewed 153 of 401 patients (<18 years) with SeLECTS whose sleep EEGs normalized (2010-2025, Chonnam National University Hospital).
RESULTS: The median age at sleep EEG normalization was 11.4 years (IQR, 10.1-13.2), with a median interval of 45.9 months (IQR, 27.0-66.8). Seizure-onset age correlated positively with EEG normalization age (R = 0.457) and negatively with the interval to normalization (R = -0.508; P < 0.001). EEG normalized younger in patients with unilateral (10.9 vs. 12.0 years, P = 0.002) or right-dominant discharges (11.2 vs. 13.0 years, P = 0.023). The EEG normalization interval increased with a longer gap between the first and second seizures (R = 0.279; P = 0.001). It was shorter in unilateral discharges (28.1 vs. 53.9 months; P < 0.001), and longer in the polytherapy group (57.3 vs. 43.5 months; P = 0.006). Polytherapy was more frequent in early childhood (50.5 % vs. 21.0 %; P = 0.005), and in patients with Todd’s paralysis (71.4 % vs. 26.0 %; P = 0.019), daytime seizures (64.7 % vs. 23.5 %; P < 0.001), or attention deficit/hyperactivity disorder (ADHD; 66.7 % vs. 25.7 %; P = 0.015).
CONCLUSION: EEG remission is associated with seizure-onset age and dipole findings, whereas the need for polytherapy is influenced more by atypical clinical than electrical biomarkers.
PMID:41004874 | DOI:10.1016/j.braindev.2025.104449
