Abstracts

Self-limited epilepsy with centrotemporal spikes (SeLECTs) is a well-known pediatric epilepsy with a favorable prognosis. While centrotemporal discharges in EEGs typically resolve with age, biomarkers predicting normalization and the need for polytherapy remain insufficiently explored. This study aimed to identify electroclinical biomarkers associated with the age and interval to sleep EEG normalization, and polytherapy needs in patients with SeLECTs.

We retrospectively reviewed 153 of 401 patients (< 18 years) diagnosed with SeLECTs at Chonnam National University Hospital between January 2000 and February 2025, all of whom had normalized sleep EEGs after their last seizure.

The median age at sleep EEG normalization was 11.4 years (IQR, 10.1–13.2), with a median interval of 45.9 months (IQR, 27.0–66.8). Polytherapy (≥2 ASMs) was used in 43 patients (28.1%). Seizure-onset age correlated positively with EEG normalization age (R = 0.457), but negatively with the interval from seizure onset to sleep EEG normalization (R = –0.508; P < 0.001). Sleep EEG normalized younger in patients with unilateral (10.9 vs. 12.0 years, P = 0.002) or right-dominant discharges (11.2 vs. 13.0 years, P = 0.023). The interval between the first and second seizures (N = 127) was positively correlated with interval to sleep EEG normalization (R = 0.279; P = 0.001). The EEG normalization interval was shorter in unilateral discharges (28.1 vs. 53.9 months; P < 0.001), and longer in the polytherapy group (57.3 vs. 43.5 months; P = 0.006). Polytherapy was more common in early childhood (50.5% vs. 21.0%; P = 0.005), and in patients with Todd’s paralysis (71.4% vs. 26.0%; P = 0.019), seizures during wakefulness (64.7% vs. 23.5%; P < 0.001), or ADHD (66.7% vs. 25.7%; P = 0.015).  

Several electroclinical biomarkers may help predict sleep EEG normalization and the need for polytherapy in SeLECTs.

This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.