Simultaneous or sequential onset of childhood absence epilepsy and childhood benign epilepsy with centrotemporal spikes: a VEEG and clinical feature study / 中华神经医学杂志

ABSTRACT

Objective:To analyze the video electroencephalogram (VEEG) and clinical features of simultaneous or sequential onset of childhood absence epilepsy (CAE) and childhood benign epilepsy with centrotemporal spikes (BECTS).Methods:Seven patients with simultaneous or sequential onset of CAE and BECTS admitted to Neurology Center, Beijing Tiantan Hospital from January 2016 to July 2023 were chosen. The clinical features, VEEG, treatments and prognoses of these patients were retrospectively analyzed. PubMed database was searched for articles on simultaneous or sequential onset of CAE and BECTS from January 2002 to July 2023, and studies with 3 or more cases of simultaneous or sequential onset of CAE and BECTS were included. Clinical characteristics of these patients in various studies were compared.Results:(1) The mean onset age in these 7 patients was 6.28 years, ranged from 4 to 8 years. CAE was recorded in 2 patients without clinical manifestation of BECTS during the course of disease progression; simultaneous or sequential onset of CAE and BECTS was recorded in 5 patients. Of the 7 patients, 2 effectively accepted valproate sodium (VPA) monotherapy, and 5 required additional antiepileptic drugs. Although all patients had well-controlled seizures and no developmental delays, 3 had learning disabilities, 3 had attention deficit hyperactivity disorder (ADHD), and 2 had anxiety. Wechsler Intelligence Scale for Children-III (WAIS-III) showed that 1 patient had below average intelligence and 6 had average intelligence. VEEG of all 7 patients showed simultaneous or sequential absence seizures and centrotemporal spikes. (2) Four studies were included in PubMed database. Combined with our study, these 5 sutdies indicated significant differences in onset age in patients with simultaneous or sequential onset of CAE and BECTS ( P<0.05), but no significant differences in simultaneous VEEG manifestations occurred or not and disease comorbidities or not in CAE and BECTS patients ( P>0.05). Conclusion:Patients with simultaneous or sequential onset of CAE and BECTS have different onset age, good overall prognosis and good response to anti-epileptic drugs, and trend to have complicated cognitive impairment.