The fate of spikes in self-limited epilepsy with centrotemporal spikes: Are clinical and baseline EEG features effective?

Çağatay Günay, Gamze Sarıkaya Uzan, Özlem Özsoy, Semra Hız Kurul, Uluç Yiş

OBJECTIVE: We aimed to evaluate the effects of demographic, clinical and electroencephalographic features on spike reduction with a focus on the first EEG characteristics. METHODS: This single-center retrospective study was conducted on SLECTS patients of both sexes with at least two years follow-up and at least two EEG recordings in which spike wave indexes (SWI) were calculated and classified as three groups: good response (a decrease of ≥50% in SWI), moderate response (a decrease of <50%), and no response (an increase/no decrease). RESULTS: In 136 patients enrolled, the median interval between first and last EEGs was 35.5 (12-108) months. Median SWI in the first and last EEGs were 39% (7.6-89%) and 0 (0-112%). Good and moderate responses were observed in 26 (19.1%) and 105 (77.2%) patients. No response group included five patients (3.7%). Gender, seizure onset age, psychiatric diseases, seizure characteristics (semiology, duration, and relationship to sleep), last EEG time, and lateralization/localization features in the first EEG did not have a statistically significant effect on the SWI change. SWI change groups were significantly different in the presence of interhemispheric (p= 0.011) and interhemispheric (p < 0.001) generalizations. Phase reversal was significantly higher in no response group (p= 0.029). Valproate was the best suppressor of SWI (p= 0.033). CONCLUSION: Generalization and phase reversal in the first EEG in SLECTS had negative effects on the spike reduction. The most effective ASM in reducing spikes was valproate.

Keywords: Electroencephalogram (EEG); Rolandic epilepsy; Spike rate; Spike wave index

Çağatay Günay
Dokuz Eylul University Faculty of Medicine
Turkey

Gamze Sarıkaya Uzan
Dokuz Eylul University Faculty of Medicine
Turkey

Özlem Özsoy
Dokuz Eylul University Faculty of Medicine
Turkey

Semra Hız Kurul
Dokuz Eylul University Faculty of Medicine
Turkey

Uluç Yiş
Dokuz Eylul University Faculty of Medicine
Turkey
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Çağatay Günay 
Dokuz Eylul University Faculty of Medicine Turkey