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Care and three-year outcomes of children with Benign Epilepsy with Centro-Temporal Spikes in England.

Published version
Peer-reviewed

Repository DOI


Type

Article

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Authors

Steinruecke, Moritz  ORCID logo  https://orcid.org/0000-0003-1647-4481
Gillespie, Conor 
Ahmed, Najma 
Bandyopadhyay, Soham 
Duklas, Dorota 

Abstract

PURPOSE: Benign Epilepsy with Centro-Temporal Spikes (BECTS) is a pediatric epilepsy with typically good seizure control. Although BECTS may increase patients' risk of developing neurological comorbidities, their clinical care and short-term outcomes are poorly quantified. METHODS: We retrospectively assessed adherence to National Institute for Health and Care Excellence (NICE) guidelines relating to specialist referral, electroencephalogram (EEG) conduct and annual review in the care of patients with BECTS, and measured their seizure, neurodevelopmental and learning outcomes at three years post-diagnosis. RESULTS: Across ten centers in England, we identified 124 patients (74 male) diagnosed with BECTS between 2015 and 2017. Patients had a mean age at diagnosis of 8.0 (95% CI = 7.6-8.4) years. 24/95 (25%) patients were seen by a specialist within two weeks of presentation; 59/100 (59%) received an EEG within two weeks of request; and 59/114 (52%) were reviewed annually. At three years post-diagnosis, 32/114 (28%) experienced ongoing seizures; 26/114 (23%) had reported poor school progress; 15/114 (13%) were diagnosed with a neurodevelopmental disorder (six autism spectrum disorder, six attention-deficit/hyperactivity disorder); and 10/114 (8.8%) were diagnosed with a learning difficulty (three processing deficit, three dyslexia). Center-level random effects models estimated neurodevelopmental diagnoses in 9% (95% CI: 2-16%) of patients and learning difficulty diagnoses in 7% (95% CI: 2-12%). CONCLUSIONS: In this multicenter work, we found variable adherence to NICE guidelines in the care of patients with BECTS and identified a notable level of neurological comorbidity. Patients with BECTS may benefit from enhanced cognitive and behavioral assessment and monitoring.

Description

Keywords

Clinical audit, Epilepsy, rolandic, Learning difficulty, NICE guideline, Neurodevelopmental disorder, School progress, Humans, Child, Male, Epilepsy, Rolandic, Retrospective Studies, Autism Spectrum Disorder, Seizures, Electroencephalography

Journal Title

Epilepsy Behav

Conference Name

Journal ISSN

1525-5050
1525-5069

Volume Title

148

Publisher

Elsevier BV