Benign childhood epilepsy with centrotemporal spikes
Pierre Loiseau, MD
Hôpital Pellegrin, 33076 Bordeaux Cédex, France
Bernard Duché, MD
MANY childhood epilepsies have a favorable outcome.1 In some, however, prognostic factors can appear and take shape one year or more after onset of the disorder. In the case of benign partial epilepsy of childhood with centrotemporal spikes (BPEC) the clinician's situation with respect to the patient and the parents is much more optimistic. Key electroclinical criteria for an excellent prognosis are present, in most cases, immediately after the first seizure and on the first electroencephalographic (EEG) record. Also referred to as benign rolandic epilepsy of childhood, BPEC is placed in the group of localization-related (focal, local, partial) idiopathic epilepsies.2
The concept of BPEC as a clinical entity was slow in developing. BPEC cases were lost among major seizures, minor motor seizures and temporal lobe seizures. Early electroencephalographers noted that rolandic (centrotemporal or midtemporal) spikes were a very special EEG pattern which existed only in children and tended to disappear with increasing age.3–6 The seizures as well as the spikes vanished during puberty.7 Gibbs and Gibbs8 in 1960 were the first to correlate rolandic spikes with a common form of focal childhood epilepsy generally having a good prognosis, but they did not describe the specific clinical features of the seizures. In the sixties and early seventies, the key clinical symptoms and signs of BPEC were described in Europe9–15 and in the United States.16 Since then, many papers have given more details on the clinical17,18 and EEG19–22 symptomatology, on the genetics,23,24 on the course,25–29 and on. . .