title: The prevalence of atypical presentations and comorbidities of benign childhood epilepsy with centrotemporal spikes.
abstract: OBJECTIVE
  Benign childhood epilepsy with centrotemporal spikes (BCECTS) is the most common epileptic syndrome in childhood. The outcome is usually excellent, but there are some atypical forms of BCECTS with less favorable outcomes. The aim of this study was to delineate the frequency of these atypical features among patients with BCECTS.
  
  
  METHODS
  We conducted a retrospective chart study by retrieving the medical records of all consecutive patients with BCECTS who were evaluated in four pediatric neurology outpatient clinics in Israel between the years 1991 and 2008.
  
  
  RESULTS
  A total of 196 patients with BCECTS were identified (78 female and 118 male; mean age at time of diagnosis 7.64 years, range 1.5-14). The mean duration of follow-up was 4.43 years (range 2-11). Nine patients (4.6%) developed electrical status epilepticus in slow waves sleep (ESES) during follow-up, four (2%) had Landau-Kleffner syndrome, three (1.5%) had BCECTS with frequent refractory seizures, two (1%) had BCECTS with falls at presentation, one (0.5%) had a "classic" atypical variant, and one (0.5%) had oromotor dysfunction. None had rolandic status epilepticus. Sixty-one patients (31%) had attention deficit hyperactivity disorder (ADHD), 43 (21.9%) had specific cognitive deficits, and 23 (11.7%) had behavioral abnormalities, including aggressiveness, anxiety disorders, depression, and pervasive developmental disorder (PDD).
  
  
  CONCLUSIONS
  The prevalence of most atypical forms of BCECTS other than ESES is low. There is, however, a high prevalence of ADHD and specific cognitive deficits among patients with BCECTS.
authors.affiliation: Pediatric Neurology Unit, Tel Aviv, Sourasky, Medical Center, Tel Aviv, Israel.
authors.forename: Eliel
authors.initials: E
authors.lastname: Tovia
authors.forename: Hadassa
authors.initials: H
authors.lastname: Goldberg-Stern
authors.forename: Bruria
authors.initials: B
authors.lastname: Ben Zeev
authors.forename: Eli
authors.initials: E
authors.lastname: Heyman
authors.forename: Nathan
authors.initials: N
authors.lastname: Watemberg
authors.forename: Aviva
authors.initials: A
authors.lastname: Fattal-Valevski
authors.forename: Uri
authors.initials: U
authors.lastname: Kramer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D019305:Epilepsy, Rolandic / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies