[Prognosis of benign childhood epilepsy with centrotemporal spikes: clinical utility of objective diagnostic criteria].

Abstract:

INTRODUCTION:Studies about childhood epilepsy with centrotemporal spikes (CECTS), most of them retrospective, include patients with highly heterogeneous features. AIM:To investigate the prognostic value of objective diagnostic criteria for CECTS applied at six month of evolution of epilepsy. PATIENTS AND METHODS:All patients with one or more unprovoked epileptic seizures (n = 827) were prospectively included. We investigated prognosis and clinical features of five groups of patients defined in accordance with the presence of centrotemporal spikes (CTS) and the following signs: speech arrest or dysarthria; hemifacial tonic or clonic contractions; and prominent sialorrhea. Group A (two or three signs and CTS), group B (one sign and CTS), group C (no sign and CTS), group D (two or three signs without CTS), group E (tonic-clonic generalized seizures and CTS). RESULTS:52, 12, 12, 22 and 8 cases were classified respectively into groups A, B, C, D and E. Patients of the five groups presented a similar semiology but differences in the probability of attaining a 3-years remission without antiepileptic treatment were observed: group A (98%), group B (92%), group C (90%), group D (77%), group E (100%). The difference between groups A and D was statistically significant. CONCLUSION:Cases of group A could be considered as well-defined cases of CECTS; cases of groups B, C and E, as probable cases of CECTS, and cases of group D must be excluded from the diagnosis. TITLE:Pronóstico de la epilepsia de la infancia con puntas centrotemporales: utilidad clínica de unos criterios diagnósticos objetivos. :Introducción. Los estudios sobre el pronóstico de la epilepsia de la infancia con puntas centrotemporales (EIPCT), la mayoría retrospectivos, incluyen a pacientes con características clínicas muy heterogéneas. Objetivo. Investigar el valor pronóstico de unos criterios diagnósticos objetivos de EIPCT aplicados a los seis meses de evolución de la epilepsia. Pacientes y métodos. Se incluyó prospectivamente a todos los pacientes con una o más crisis epilépticas no provocadas (n = 827). Se investigó el pronóstico y las características clínicas de cinco grupos de pacientes, definidos según la presencia de punta-onda centrotemporal (POCT) y de los siguientes signos: bloqueo del habla o disartria, contracciones tónicas o clónicas hemifaciales y sialorrea prominente. Grupo A (dos o tres signos y POCT), grupo B (un signo y POCT), grupo C (ningún signo y POCT), grupo D (dos o tres signos sin POCT), grupo E (crisis tonicoclónicas generalizadas y POCT). Resultados. Se clasificaron 52, 12, 12, 22 y 8 casos, respectivamente, en los grupos A, B, C, D y E. Los pacientes de los cinco grupos presentaron una semiología similar, pero se observaron diferencias en la probabilidad de alcanzar una remisión inicial de tres años sin crisis ni tratamiento antiepiléptico: grupo A (98%), grupo B (92%), grupo C (90%), grupo D (77%) y grupo E (100%). La diferencia entre los grupos A y D fue estadísticamente significativa. Conclusión. Los casos del grupo A podrían considerarse como casos bien definidos de EIPCT; los casos de los grupos B, C y E, como casos probables, y los del grupo D deberían excluirse del diagnóstico.

journal_name

Rev Neurol

journal_title

Revista de neurologia

authors

Ramos-Lizana J,Martínez-Espinosa G,Jiménez-Iniesta E,Aguirre-Rodríguez J

doi

10.33588/rn.7006.2019357

subject

Has Abstract

pub_date

2020-03-16 00:00:00

pages

206-212

issue

6

eissn

0210-0010

issn

1576-6578

pii

rn2019357

journal_volume

70

pub_type

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