Clinical profile and electroencephalogram characteristics of children with self-limited epilepsy with centro-temporal spikes attending paediatric neurology clinic, Teaching Hospital, Karapitiya, Sri Lanka

Introduction: Self-limited epilepsy with centro-temporal spikes (SLECTS) is the commonest type of epilepsy in childhood. Though considered a benign condition in the past, there is growing evidence of its multiple neuropsychiatric involvement. Antiepileptic drugs (AEDs) were not recommended in children with SLECTS due to its benign nature.

Objectives: To describe the clinical profile and EEG characteristics of children with SLECTS followed up at the paediatric neurology unit, Teaching Hospital Karapitiya.

Method: A descriptive cross-sectional study, using an interviewer-administered questionnaire, was carried out at the paediatric neurology clinic, THK from December 2021 to February 2022.

Results:A total of 113 children with SLECTS was included in the study. Of them, 61.1% were males. Mean age of the sample was 10 ± 2.8 years. Mean age of onset of seizures was 7 ± 2.5 years. Majority (87.5%) were diagnosed after one seizure episode and 13.3% had a history of febrile seizures. Developmental delay was evident among 5 (4.4%) patients. Speech arrest (91.2%), hypersalivation (74.3%) and hemifacial sensory-motor seizures (56.6%) were the main manifestations; 87.6% had seizures at night. Abnormal EEGs were found in 110 (97.3%) patients and 51.3% had bilateral typical SLECTS changes in the EEG. Twenty-seven (23.9%) parents had concerns about their children's school performance. Behavioural problems were reported in 37 (32.7%). Child psychiatry referrals were done on 12 (10.2%) occasions. AEDs were used on 72.6% of patients and 27.4% had achieved remission. Sodium valproate was the most widely used AEDs (79.6%). Most of the patients were managed with monotherapy.

Conclusions: There was male predominance. Mean age of onset of seizures was around 7 years; 87.5% were diagnosed after one seizure episode and 87.6% had seizures at night. The predominant EEG characteristic was bilateral typical centro-temporal spikes and waves. Speech arrest (91.2%), hypersalivation (74.3%) and hemifacial sensory-motor seizures (56.6%) were the main manifestations of the seizure.

Sri Lanka Journal of Child Health, 2023; 52(1): 33-38