Features and relevant factors concerning the ecological executive function of patients with benign epi-lepsy children with centrotemporal spikes / 中华行为医学与脑科学杂志

Objective To explore features and relevant factors affecting the ecological executive function in benign epilepsy children with centrotemporal spikes(BECT). Methods The behavior rating in-ventory of executive function (BRIEF) parental questionnaires were used to evaluate the executive function of 50 children with BECT (BECT group) and 50 normal children (control group) matched with BECT group (sex,age,education years). The differences of ecological executive function between the two groups were compared. Results (1)In BECT group,the scores of global executive composite (GEC),behavioral regula-tion index (BRI) and metacognition index (MI) ((51. 64±10. 30),(49. 02±8. 98),and (52. 78±10. 92), respectively) were significantly higher than those of the control group ((45. 70± 6. 55),(44. 96± 5. 35), (46. 72±6. 96),respectively,t=3. 440,2. 747,3. 309, all P<0. 05). Meanwhile,in BECT group,inhibit ((49. 90±10. 62),initiate (51. 76±11. 90),and working memory index scores (55. 58±10. 95) were also higher than those of the control group (44. 94± 6. 05,43. 74± 7. 63,47. 54± 7. 15,respectively,t=2. 870, 4. 014,4. 345, all P<0. 05). ( 2) Patients' condition had a negative predictive effect on inhibition ( β= -8. 926,P=0. 002),BRI ( β=-5. 422, P=0. 025), working memory ( β=-4. 980, P=0. 008), MI ( β=-4. 962,P=0. 034)and total score of scale( β=-6. 164,P=0. 004); attack times had a positive predictive effect on BRI(β=2. 555,P=0. 002),task initiation( β=7. 471,P<0. 01),working memory(β=5. 384,P<0. 01),MI (β=4. 726,P<0. 01) and total score of scale(β=4. 221,P<0. 01). Conclusion Children with BECT have ecological executive dysfunction. The number of epileptic seizures and the control of the disease are the main factors affecting the ecological executive function.

A propósito de la denominada epilepsia benigna con puntas centrotemporales (rolándicas) / Apropos the so-called benign epilepsy with centrotemporal spikes (rolandic)

La epilepsia benigna con puntas centrotemporales o rolándicas se caracteriza por crisis parciales motoras en la infancia y un electroencefalograma en que observan descargas de puntas en las regiones centrotemporales medias. Ha sido reconocida como benigna, debido a la ausencia de déficits neurológicos evidentes; sin embargo, en los últimos años en la literatura médica internacional han aparecido varias publicaciones que cuestionan su evolución favorable. El objetivo de este trabajo es actualizar algunos criterios que no concuerdan con el buen pronóstico referido inicialmente. Representa una etapa fundamental en la historia de la epilepsia, debido a que es la primera vez que se describió una epilepsia focal o parcial en la que se presumía que no existía una lesión cortical subyacente. La evolución de esta forma de epilepsia puede mostrar elementos que niegan su benignidad. Se recomienda en un futuro efectuar en nuestro servicio un estudio que confirme los criterios expuestos en la literatura médica internacional(AU)

Benign epilepsy with centrotemporal spikes, aka benign rolandic epilepsy, is characterized by partial motor crisis in childhood and electroencephalography showing point discharges in medial centrotemporal regions. The condition has been recognized as benign due to the absence of evident neurological deficits. However, in recent years several publications have appeared in international medical literature in which its favorable evolution is questioned. The objective of the present study is to update some criteria differing from the good prognosis initially stated. It constitutes a fundamental stage in the history of epilepsy, since for the first time a case of focal or partial epilepsy was being described in which presumably there did not exist an underlying cortical lesion. The evolution of this form of epilepsy may display features denying its benignity. It is recommended that in the future a study be conducted in our service confirming the criteria expounded in international medical literature(AU)

Theory of mind in benign epilepsy children with centrotemporal spikes / 中华行为医学与脑科学杂志

Objective To investigate the theory of mind ( TOM) and eye basic emotion recognition in benign epilepsy children with centrotemporal spikes( BECT) . Methods Totally 51 BECT patients( BECT group) and 51 healthy controls( control group) were studied by Yoni task and Eye Basic Emotion Discrimi-nation Task (EBEDT). Results ①Compared with healthy controls,BECT got significantly lower score ((54. 02±6. 03) vs (58. 04±5. 41),F(1,100)=10. 34,P<0. 05))in Yoni task,especially in affective(hot) TOM .②There was no significant difference between the BECT group(M(P25,P75):103(96,108)) and the control group(M(P25,P75):105(96,110))in the total score of Eye Basic Emotion Discrimination Task(Z=-1. 37,P>0. 05),but got significantly lower score in recognizing sadness(M(P25,P75):16(14,17) vs 18 (15,19),Z=-3. 05,P<0. 05)and fear(M(P25,P75):15(14,17) vs 16(16,18),Z=-2. 21,P<0. 05).③Pearson or Spearman correlation analysis showed that there was no significant correlation between the total score of TOM and the age,age of onset, education,seizure total number,MMSE,the Digital Span test, the verbal fluency test and eye basic emotion recognition ( r=-0. 257-0. 908,all P>0. 05) . Conclusion BECT children have impairments in sadness and fear emotion recognition and TOM aspects.

Effects of Antiepileptic Drugs on Language Abilities in Benign Epilepsy of Childhood with Centrotemporal Spikes

BACKGROUND AND PURPOSE: This study is to assess the responsiveness of electroencephalography (EEG) abnormalities and their effects on language ability after initiating different types of antiepileptic therapy in children with newly diagnosed benign epilepsy of childhood with centrotemporal spikes (BECTS). METHODS: The records of patients newly diagnosed with BECTS (n=120; 69 males) were reviewed retrospectively. The patients were randomly treated with lamotrigine, oxcarbazepine, or topiramate monotherapy, and underwent at least two EEG and standardized language tests. Effects were compared using Pearson’s chi-square tests and paired t-tests. RESULTS: The recurrence rates for seizures in the lamotrigine, topiramate, and oxcarbazepine groups were 19.4%, 21.7%, and 11.4%, respectively, while complete or partial recovery (as indicated by EEG) occurred in 32%, 39%, and 16% of the patients. Patients in the lamotrigine group showed significant improvements in all parameters assessed by the Test of Language Problem Solving Abilities, except for ‘determining cause.’ Patients in the oxcarbazepine group also showed improvements, except for ‘making inferences’ (p < 0.05). Most linguistic index scores were worse in the topiramate group except for Mean Length of Utterance in Words. Patients in the lamotrigine and oxcarbazepine groups showed significant improvements in the receptive language test (p < 0.05). EEG improvements were not related to language ability. CONCLUSIONS: The improvements in language and problem-solving performance in children with BECTS were greater for lamotrigine and oxcarbazepine than for topiramate. However, EEG remission did not imply that language function would be improved after the treatments.

Decision-making under risk condition in benign epilepsy children with centrotemporal spikes / 中华行为医学与脑科学杂志

Objective To investigate the ability of decision-making under risk condition in benign epilepsy children with centrotemporal spikes (BECT).Method Seventy-eight BECT patients and seventyfive healthycontrols were studied by Iowa Gambling Task (IGT) with inexplicit probability and Game of Dice Test (GDT) with explicit probability.Results (1) There was a significant difference in IGT task scores between the two group (t=-2.56,P＜0.05).The total number of advantageous choices in IGT were lower in BECT group (49.35±5.38) than that in healthy control group (52.24±6.23).BECT group (-1.41 ± 10.60) performed worse on task than healthy control group (4.43±11.88),and the difference was statistically significant (t=-3.21,P＜0.05).The control group scored higher on Blockl,Block4 and Block5 than that of BECT group (P＜0.05).(2) There was no significant difference between the BECT group (4.42±7.74) and the control group(5.49±6.81) in the GDT test scores (t=-0.91,P=0.37).(3) Pearson correlation analysis showed that there was no significant correlation between the age,age of onset,education,seizure frequency and onset duration and the score of IGT and GDT (r =-0.091-0.274,all P ＞ 0.05).Conclusion There is no significant decision-making disability in children with BECT under the condition of certain risk probability,while there is significant impairment under the condition of uncertain risk probability.The decision-making disability may be associated with impaired frontal lobe function.

Attention networks in benign epilepsy children with centrotemporal spikes / 中华神经科杂志

Objective To investigate the characteristics of attention networks impairment in benign epilepsy children with centrotemporal spikes.Methods The attention network test was performed in benign epilepsy children with centrotemporal spikes (n =75) and normal controls (n =75) on the efficiency of three anatomically defined attention networks:alerting,orienting,and execrtive control.Results The correct rate of attention network test was significantly lower in benign epilepsy children with centrotemporal spikes (95.77％ ± 5.63％) than that in normal controls (98.55％ ± 1.80％ ; t =4.063,P ＜ 0.05).The total average response time was significantly longer in benign epilepsy children with centrotemporal spikes ((946.87 ± 199.82) ms) than that in normal controls ((729.00 ± 146.75) ms ; t =-7.611,P ＜ 0.05).The orienting network effect (29 (12,56)ms) was lower in benign epilepsy children with centrotemporal spikes than in normal controls (51 (21,78) ms; Z =-2.771,P =0.006).The executive control network effect was higher in benign epilepsy children with centrotemporal spikes (80 (50,105) ms) than in normal controls (57 (25,88) ms; Z =-2.146,P =0.032).However,the difference in alerting network effects between the two groups was not statistically significant (P ＞ 0.05).Logistic regression analysis showed that the age on onset of the disease was an independent risk factor for the correct rate of attention network test and the total average response time (OR =1.830,95％ CI 1.193-2.807,P =0.006 ; OR =1.635,95％ CI 1.176-2.275,P =0.003).Conclusions The benign epilepsy children with centrotemporal spikes have impairment of attention networks.The age on onset of the disease has a significant impact on the attention of children with rolandic epilepsy.

Association of language dysfunction and age of onset of benign epilepsy with centrotemporal spikes in children / 中国小儿急救医学

Objective To assess language function in children with benign epilepsy with centrotemporal spikes in children(BECTS) and its association with the age of epilepsy onset.Methods We assessed language function in 63 children with BECTS and 30 age and sex matched controls by the subtest of CWISC.Results Children with BECTS performed significantly worse on all language tasks as compared to controls and overall better language function was positively correlated with older age of the child.Early age at seizure onset demonstrated significant negative correlation with language dysfunction,age below 6 years being related to the lowest performance scores(P ＜ 0.05).There was no relationship between the language function and the laterality of epileptic focus,seizure treatment status,or the duration of epilepsy(P ＞ 0.05).There was significant relationship between the language dysfunction and onset age of epilepsy (P ＜ 0.05).Conclusion Children with BECTS have language difficulties that are more pronounced in younger age group.Despite better language functioning in older children with BECTS,their verbal abilities remain inferior to those of children without epilepsy.Early age at seizure onset is a significant factor predicting worse language functioning in children with BECTS.

Clinical and electroencephalographic characteristics of benign occipital epilepsy of childhood in two tertiary Brazilian hospitals / Características clínicas e eletrencefalográficas da epilepsia occipital benigna da infância em dois hospitais terciários brasileiros

This study intended to investigate the clinical and electroencephalographic benign occipital epilepsy of childhood (BOEC) characteristics in a population sample of patients from two tertiary Brazilian hospitals. We analyzed retrospectively 4912 electroencephalograms (EEGs) records, and the included patients were submitted to a new clinical and EEG evaluation. Were included 12 (0.92 percent) patients; 4 (33.3 percent) with criteria for early BOEC; 6 (50 percent) for late form and 2 (16.7 percent) with superimposed early and late onset forms. After new investigation, 2 (16.7 percent) had normal EEG; 4 (33.3 percent) had paroxysms over the occipital region; 3 (25 percent) over the temporal posterior regions and 3 (25 percent) over the posterior regions. Sharp waves were the predominant change, occurring in 8 (66.6 percent); spike and slow wave complexes in 1 (8.3 percent) and sharp and slow wave complexes in 1 (8.3 percent). Vomiting, headache and visual hallucinations were the most common ictal manifestations, presented in 100 percent of patients with superimposed forms. Vomiting were absent in the late form and headache was present in all forms of BOEC.

Este estudo teve como objetivo investigar as características clínicas e eletrencefalográficas da epilepsia occipital benigna da infância (EOBI) em uma amostra populacional de pacientes de dois hospitais terciários brasileiros. Foram analisados retrospectivamente 4912 registros de eletrencefalograma (EEG). Os pacientes incluídos foram submetidos a nova avaliação clínica e eletrencefalográfica. Foram incluídos 12 (0,92 por cento) pacientes; 4 (33,3 por cento), com critérios para EOBI de início precoce; 6 (50 por cento) para a forma tardia e 2 (16,7 por cento), com superimposição de formas de início precoce e tardio. Após nova investigação, 2 (16,7 por cento) apresentaram EEG normal; 4 (33,3 por cento) paroxismos sobre a região occipital; 3 (25 por cento) sobre a região temporal posterior e 3 (25 por cento) sobre as regiões posteriores. Ondas agudas foram a alteração predominante, ocorrendo em 8 (66,6 por cento); complexos espícula e onda lenta em 1 (8,3 por cento) e complexos onda aguda e onda lenta em 1 (8,3 por cento). Vômitos, cefaléia e alucinações visuais foram as manifestações ictais mais comuns, estando presentes em 100 por cento dos pacientes com formas superimpostas de EOBI. Vômitos não foram relatados na forma tardia e cefaléia esteve presente em todas as formas de EOBI.

Comparative study of typical and atypical benign epilepsy with centrotemporal spikes (Rolandic epilepsy) / 소아과

PURPOSE: This study aims to examine and compare the features of rolandic epilepsy. METHODS: Of 158 patients selected retrospectively, 116 had typical (group A) and 42 had atypical (group B) rolandic epilepsy, as defined by Worrall's criteria. RESULTS: The age at onset of the seizures in group Awas 8.6+/-2.0 y and 6.2+/-1.7 y in group B (P>0.05). Among the 40 patients who underwent neuroimaging studies (25 patients in group Aand 15 patients in group B), abnormal findings in group B included ventricular dilatation, mild cortical atrophy, and partial agenesis of corpus callosum. group A had no abnormal findings. The frequency of seizures was 2.0+/-1.0 and 2.3+/-1.2 per month in groups A and B respectively. Seizure control from the initial anticonvulsant treatment was achieved within 3 months in group A, and 3 to 12 months in group B. A 2-year remission rate was noted in 105 patients in group A and in 38 patients in group B. Of these, the recurrence rate after 2 y was 13 in group A and 12 in group B. CONCLUSION: Age of onset of seizures, gender, frequency of seizures before therapy, and 2-y remission rate were not significantly different in the 2 groups. However, neuroimaging abnormalities, the time to achieving seizure control from the initial anticonvulsant treatment, and the recurrence rate after being seizure-free for 2 y were significantly different in the 2 groups.

Clinical and Electroencephalography Characteristics of Benign Epilepsy with Centro-Temporal Spikes in Children / 实用儿科临床杂志

Objective To summarize the clinical and electroencephalography(EEG) characteristics of benign epilepsy with centro-temporal spikes (BECTS) in children.Methods The clinical manifestations,EEG findings,response to drug treatment and prognosis of 35 children with BECTS from Jul.2003 to Dec.2008 in the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively.Results In the 35 cases,the age of onset was 2.5 to 14.0 years old,and the peak age of onset was 6-10 years old(62.9%).Twenty-two cases mainly presented partial seizures:hemifacial convulsions,sialorrhea,sounds,limb tonic-clonic seizures,and secondary generalized seizures.Thirteen cases were only describled generalized tonic-clonic seizures.Seizures were closely related to sleep and almost occurred shortly after falling asleep or before waking up.There were 26 cases who displayed convulsion during sleeping,including noon break.The EEG features showed numerous or single spikes on one side or both sides in the central and temporal areas under the background of normal activity in interictal period.The release frequency of abnormal wave was significantly increased after falling asleep,so the EEG monitoring during sleep could improve the positive rate of BECTS.Monotherapy with low-dose anti-epileptic drug could obtain good efficacy.Twenty-five cases stopped seizures within 3 months after therapy.Thirty-three cases hadn't get seizure since drug therapy at the age of 16 years old.So far,12 cases had been stopped medicine.Conclusions BECTS mostly begins at school-aged children,which displays partial seizures or secondary generalized seizures.The seizures are closely related to sleep.EEG monitoring during sleep which shows numerous or single spikes on the centrotemporal area has crucial diagnostic value to BECTS.There is a positive response to monotherapy with low-dose anti-epileptic drug and generally the prognosis is good.

Behavior Characteristics in Children with Benign Epilepsy Combined with Centro-Temporal Spikes / 实用儿科临床杂志

Objective To explore the behavior characteristics in children with benign epilepsy combined with centro-temporal spikes(BECTS).Methods Eighty-two children with BECTS aged 2.5-3.0(2.65?2.31)years old,51 male,31 female,who were free of mental retardation assessed with Gesell developmental schedules,untreated with antiepileptic drugs,and were investigated 15 days after the latest seizure.Eighty-two healthy children with sex and age matched to the cases,53 male,29 female,aged 2.5-3.0(2.6?0.4)years old.The behavior characteristics of infants in BECTS group and control group were assessed with CBCL,including 6 behavior factors which were sleep problem,social flinches,depression,physical aspect,attacking,act of sabotage and the infants-middle school student social ability scale.Results The total scores of behavior characteristics and the scores of depression,sleep problem,attacking and act of sabotage in BECTS group were all higher than those in control group,the differences were statistically significant.However,scores of social flinches,and physical aspect in BECTS group had no significant differences compared with those of control group.There were no significant difference of social adaptive component between the BECTS and control group.Conclusions Children with BECTS have behavior disorders to some extent,but their social adaptive capacity are the same as normal children.

Concomitance of Childhood Absence Epilepsy and Benign Rolandic Spikes / 대한간질학회지

Childhood absence epilepsy (CAE) and benign epilepsy of childhood with centro-temporal spikes (BECT) are common forms of idiopathic epilepsy of childhood onset and share many features such as the marked age dependence of onset. The occurrence of generalized 3 Hz spike and waves in BECT or rolandic spikes in CAE has rarely been reported. We report 2 cases of concomitance of CAE and benign rolandic spikes. All of the two patients were female and had clinically absence seizure only. On EEG the two patients simultaneously showed centro-temporal spikes as well as ictal onset of absence seizure consisting of generalized 3 Hz spike and waves. All of the two patients have become seizure-free with valporic acid. It is rare but not impossible that (Rolandic spikes can concur with CAE rather than as a continuum between CAE and BECT), because all of the two patients have not shown BECT so far.

Influence of subclinical epileptiform discharges on mathematics cognitive function / 临床神经病学杂志

Objective To explore the influence of subclinical epileptiform discharge(SED) on mathematics cognitive function. Methods Using event-related potential (ERP) detection method by stimulation of mathematical operation,11 patients with benign epilepsy of children with centrotemporal spikes (BECTS group),who treated with Valproate sodium (VPA) and clinical seizures got under control,but had frequent SED,and 11 normal children (NC group) were detected. The results were analysed. Results Compared with NC group,the P3 latencies of all leads in BECTS group were significantly prolongation (all P