“Atypical forms” of benign epilepsy with centrotemporal spikes (BECTS): How to diagnose and guide these children. A practical/scientific approach

Parisi, Pasquale; Paolino, Maria Chiara; Raucci, Umberto; Ferretti, Alessandro; Villa, Maria Pia; Trenité, Dorothée Kasteleijn Nolst

doi:10.1016/j.yebeh.2017.08.001

Cited by 34 publications

(40 citation statements)

References 35 publications

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“…The CPE patients were recruited from the Longgang District Social Welfare Center, and diagnosed by the Department of Neurology, The Hospital of Maternal and Child Health (Longgang, China) with the following inclusion criteria: (I) older than 3 years of age and younger than 18 years of age; (II) the patients were diagnosed with clear clinical manifestations of both CP and epilepsy in accordance with the diagnosis guidelines (17, 18). Healthy children were selected from those who passed physical examinations by the Department of Physical Examination, The Hospital of Maternal and Child Health (Longgang, China) with the following standards: (I) older than 3 years of age and younger than 18 years; (II) no allergic history (e.g., food allergy, AD, and asthma); (III) no hereditary diseases (e.g., thalassemia, hereditary deafness, and phenylketonuria); (IV) no metabolic diseases (e.g., obesity, diabetes, and rheumatoid arthritis).…”

Section: Methodsmentioning

confidence: 99%

Distinct Gut Microbiota Composition and Functional Category in Children With Cerebral Palsy and Epilepsy

Huang

Feng³

et al. 2019

Front. Pediatr.

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Cerebral palsy (CP) and epilepsy are two interactive neurological diseases, and their clinical treatment can cause severe side-effects in children's development, especially when it involves long-term administration of antiepileptic drugs. Accumulating studies on the gut-brain axis indicated that the gut microbiota (GM), which participates in various neurological diseases, would provide a harmless therapeutic target for the treatment of CP and epilepsy. To explore the GM characteristics in children with both CP and epilepsy (CPE), we collected fecal samples from 25 CPE patients (CPE group) and 21 healthy children (Healthy group) for 16S rDNA sequencing. In this study, we discovered significantly higher microbial diversity in the CPE group compared to healthy group (P < 0.001). After selecting the top 15 most abundant genera in each group, we found significantly enriched Bifidobacterium, Streptococcus, Akkermansia, Enterococcus, Prevotella, Veillonella, Rothia, and Clostridium IV in the CPE group, and noticeably reduced Bacteroides, Faecalibacterium, Blautia, Ruminococcus, Roseburia, Anaerostipes, and Parasutterella. A GM co-occurrence network was also constructed, and negative correlations were discovered between Bacteroides and Lactobacillus (r = −0.768, P < 0.001, FDR < 0.001), as well as Intestinibacter and Bifidobacterium (r = −0.726, P < 0.001, FDR < 0.001). After KEGG annotation and functional enrichment, 24 functional categories exhibited different enrichment levels between the CPE and Healthy groups. The functions, associated with xenobiotics metabolism, immune system diseases, and neurodegenerative diseases, were enriched in the CPE group. Conversely, the functional categories related to the biosynthesis of secondary metabolites were reduced. Furthermore, the neurodegenerative diseases were mainly attributed to Streptococcus, while an increased risk of immune system diseases was associated with enriched Akkermansia in the CPE patients. Generally, this study characterized the GM in CPE patients, illustrated the microbial co-occurrence relationships, and detected the functional distributions of the bacteria.

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Section: Methodsmentioning

confidence: 99%

Distinct Gut Microbiota Composition and Functional Category in Children With Cerebral Palsy and Epilepsy

Huang

Feng³

et al. 2019

Front. Pediatr.

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“…Neuropsychological impairments include learning/cognitive, and behavioral problems (3)(4)(5) as well as language deficits (6). Early age at epilepsy onset, presence of new seizures, and an increased frequency of spikes in EEG during sleep and daytime can predict evolvement of BECTS to ABPE (2). Neurocognitive deficits have been correlated with ESES as it is considered as a factor that negatively affects the cognitive aspects precisely because it interferes with the cognitive functions of sleep including memory-learning process (2,7).…”

Section: Introductionmentioning

confidence: 99%

Treatment for the Benign Childhood Epilepsy With Centrotemporal Spikes: A Monocentric Study

et al. 2021

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Background and Purpose: To date, there is no specific treatment guideline for the benign childhood epilepsy with centrotemporal spikes (BECTS). Several countries recommend levetiracetam, carbamazepine, sodium valproate, oxcarbazepine, and lamotrigine as first-line drugs. Nevertheless, some of these drugs are associated with cognitive decline. Available studies that investigated the efficacy of levetiracetam and sodium valproate on BECTS involved small sample sizes. This study aimed to evaluate the efficacy of levetiracetam and sodium valproate on cognition, and to investigate the prognostic factors for BECTS as whole.Methods: Clinical data and treatment status of all patients with BECTS at Xiangya Hospital, Central South University followed from 2008 to 2013 were analyzed retrospectively. Since electrical status epilepticus in sleep (ESES) has been confirmed to play a role in cognitive deterioration, in order to evaluate the response to drugs and their cognitive effects, we created two groups of patients according to the levels of spike wave index (SWI): group 1; 0–50% SWI and group 2; >50% SWI at the last follow up.Results: A total of 195 cases were enrolled: 49.7% received monotherapies, 24.1% duotherapies and 27.2% polytherapies. Medications included; levetiracetam plus other drug (s) (75.9%), levetiracetam alone (32.8%), sodium valproate plus other drug (s) (31.3%), and sodium valproate alone (5.1%). After 2 years of treatment and follow up, 71% of the cases had a good seizure outcome, 15.9% had an improvement of SWI, and 91.7% had a normal DQ/IQ. Sodium valproate combined with levetiracetam, and sodium valproate alone correlated with good improvement of SWI, whereas, focal spikes were linked with poor improvement. For both groups (group 1 and group 2): monotherapy, levetiracetam alone, and a normal DQ/IQ at seizure onset correlated with good cognitive outcomes, in contrast, polytherapy, sodium valproate plus other drug (s), levetiracetam plus sodium valproate, an initial SWI of ≥85%, and multifocal spikes were linked to cognitive deterioration.Conclusions: Monotherapy, particularly levetiracetam seems to be a good first-line therapy which can help in normalizing the electroencephalograph and preventing cognitive decline. Polytherapy, mostly the administration of sodium valproate seems to relate with poor cognition, therefore, it is recommended to avoid it.

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“…It occurs predominantly between the ages of seven to ten and is more common in males (Panayiotopoulos et al, 2008 ; Callenbach et al, 2010 ). Interictal electroencephalography (EEG) typically shows a normal background with high amplitude centrotemporal spikes (Parisi et al, 2017 ). Although BECTS patients are believed to have good prognoses, a series of studies have gradually questioned the concept of BECTS as benign (Loiseau and Duché, 1989 ; Genizi et al, 2012 ; Ciumas et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Frequency-Dependent Interictal Neuromagnetic Activities in Children With Benign Epilepsy With Centrotemporal Spikes: A Magnetoencephalography (MEG) Study

Zhang

Shi

et al. 2020

Front. Hum. Neurosci.

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Objective: This study aimed to investigate interictal neuromagnetic activities in the lowto high-frequency ranges in patients with benign epilepsy with centrotemporal spikes (BECTS), especially those without interictal epileptiform discharges (IEDs). Methods: We studied 21 clinically-diagnosed BECTS patients and 11 age-matched healthy controls (HC) using high-sampling magnetoencephalography (MEG). Neuromagnetic sources were assessed with accumulated source imaging (ASI). The MEG data were analyzed in seven frequency bands. The MEG recordings distinguished BECTS without IEDs (n = 10) from those with IEDs (n = 11) and HC (n = 11). Results: At 1-4 Hz, the neuromagnetic activities in healthy subjects tended to locate at the precuneus/posterior cingulate, while those of the BECTS patients without IEDs tended to locate at the medial frontal cortex (MFC) compared to BECTS patients with IEDs. The MEG source imaging at 30-80 Hz revealed that BECTS patients without IEDs had higher occurrences of interictal brain activity in the medial temporal lobe (MTL) compared to controls and the brain activity strength seemed to be weaker. There was a significant correlation between the source strength of the interictal gamma oscillations of BECTS patients without IEDs and the duration of epilepsy. Conclusions: IEDs might disrupt the default mode network (DMN). Aberrant brain activities in BECTS patients without IEDs were associated with cognitive areas of the brain. The strength of gamma oscillations in the chronic epilepsy state reflected the duration of BECTS.

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“Atypical forms” of benign epilepsy with centrotemporal spikes (BECTS): How to diagnose and guide these children. A practical/scientific approach

Cited by 34 publications

References 35 publications

Distinct Gut Microbiota Composition and Functional Category in Children With Cerebral Palsy and Epilepsy

Distinct Gut Microbiota Composition and Functional Category in Children With Cerebral Palsy and Epilepsy

Treatment for the Benign Childhood Epilepsy With Centrotemporal Spikes: A Monocentric Study

Frequency-Dependent Interictal Neuromagnetic Activities in Children With Benign Epilepsy With Centrotemporal Spikes: A Magnetoencephalography (MEG) Study

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