Thirty-two children with benign childhood epilepsy with centrotemporal spikes (BECTS) were studied for a mean period of 27.6 months. The characteristics of the seizures, electroencephalogram (EEG), WISC-III and School Performance Test were compared at the start and end of the study. Nine (28.1%) children continued having seizures. Epileptiform activity (EA) on the EEG reduced in number and was no longer recorded in 6 (18.7%) children. There was a significant improvement in the performance and perceptual organization IQ values. The improvement in reading performance failed to reach statistical significance. The performance in arithmetic worsened in 43.7% of the children, and this was associated with the persistence of epileptic seizures. There were no significant correlations between changes in cognitive aspects and characteristics of EA. There is a need to continue this study, and also search for other factors influencing the evolution of cognitive abilities in children with BECTS. Key words: benign childhood epilepsy with centrotemporal spikes, rolandic epilepsy, epileptiform activity, cognition, rolandic spikes.Epilepsia benigna da infância com pontas centrotemporais: aspectos evolutivos clínicos, cognitivos e do EEg rEsumo Foram estudados aspectos evolutivos clínicos, cognitivos e eletrencefalográficos (EEG) de 32 crianças com epilepsia benigna da infância com pontas centrotemporais (EBICT) acompanhadas por 27,6 meses. Foram comparadas as características das crises, do EEG, do WISC-III e do Teste de Desempenho Escolar ao início e ao final do estudo. Nove (28,1%) crianças continuaram apresentando crises. A atividade epileptiforme (AE) ao EEG reduziuse em número e não mais foi registrada em 6 (18,7%) crianças. Houve melhora significativa nos QI de execução e de organização perceptual. A melhora do desempenho em leitura não alcançou significância estatística, enquanto em 43,7% das crianças houve piora em aritmética. Esta foi associada à persistência de crises epilépticas. Não houve correlações significativas entre aspectos cognitivos e características da AE. Há necessidade de estudar até a remissão total das crises e da AE, assim como procurar outros fatores que influenciem a evolução das habilidades cognitivas das crianças com EBICT. Palavras-chave: epilepsia benigna da infância, eletrencefalograma, atividade epileptiforme, cognição.
Benign childhood epilepsy with centrotemporal spikes (BECTS) is common during childhood, but there are few reports in the literature recording the EEG during a seizure. We studied an 8-year-old boy with oropharyngeal seizures during wakefulness and sleep. Both his neuropsychomotor development and neurological examination were normal. While awake, the subjects's electroencephalogram (EEG) showed normal background activity and epileptiform activity characterized by spikes in the temporal regions (mid and anterior), central region of the right cerebral hemisphere and in the median central and parietal regions. During sleep, his EEG recorded an epileptic seizure that lasted 46 seconds. In the initial phase, the EEG showed an increase in the number of spikes with higher potential in the median central and parietal regions, followed by slow waves associated with the increase in slow waves in the right hemisphere. This was followed by a brief decrease in amplitude of the background activity, and then by rhythmic, diffuse discharges predominantly in the right centrotemporal region, of sharp waves at 12-13 Hz, with increasing potential. Slow waves of high amplitude then occurred for 5 seconds, and finally very high potential spikes reappeared in the central and temporal regions of the right cerebral hemisphere with normalization of the background activity. During these critical phases of the EEG, clonic lip movements and pouting could be observed with the mouth locked shut, associated with "throat noises," but there were no other motor manifestations. The child did not wake up during the seizure and there were no postictal signs or symptoms. Although there are some aspects in common in recordings of BECTS seizures, such as a reduction in amplitude followed by rhythmic discharges of increasing amplitude, differences exist that possibly correspond to the diverse characteristics of the electrical generators.
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