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Clinical and electroencephalographic characteristics of childhood epilepsy with centrotemporal spikes for antiseizure medications: monotherapy versus dualtherapy in a multicenter cohort study

This multicenter study aimed to characteristics in children with CECTS in a national large cohort consisted of children with monotherapy or dualtherapy. A total of 706 children with CECTS who were followed up from six clinics, 2010-2020. The study group were divided into three groups according to the first seizure occurrence age. The predictive value of EEG parameter (spike and wave index-SWI) was evaluated for the selection of antiseizure medication and for definition of ADHD. ROC curves were determine the predictive value of SWI for seizure outcome, antiseizure medications. Mean age was 8.18±3.35 years. The valproic acid (VPA) group had the shortest time to the achievement of 50% reduction in seizures after monotherapy. LEV was superior to CBZ with regard to its effectiveness in controlling seizures and reducing the burden of interictal discharges, while VPA achieved the highest EEG response (60.8%) Presence of bilateral EEG findings was the most important risk factor for dual therapy An SWI value of ≥5.5 in subsequent EEG recordings was considered to have a diagnostic value for the use of LEV as the initial drug . The absence of ADHD findings in patients with decreased SWI values on subsequent EEG recordings was diagnostic. This multicenter cohort study provide that the presence of bilateral EEG findings was the most important risk factor for indicating dual therapy. The decrease in SWI in subsequent EEG recordings in patients with ADHD shows the importance of drug use.
Keywords: Childhood epilepsy with centrotemporal spikes (CECTS), anti-seizure medication, spike-wave index