title: Factors Predicting Poor Response to Initial Therapy in Benign Childhood Epilepsy with Centrotemporal Spikes (BCECTS).
abstract: OBJECTIVE
  Benign childhood epilepsy with centrotemporal spikes (BCECTS) is the most common pediatric focal epilepsy syndrome and typically has positive clinical outcomes. However, a few patients experience recurrent seizures, and therefore, require treatment with antiepileptic drugs (AEDs). This study aimed to identify risk factors associated with poor response to initial AED therapy in BCECTS patients.
  
  
  METHODS
  We retrospectively reviewed the files of 57 patients who were diagnosed with BCECTS between January 2008 and September 2013. Patients not being treated with AEDs have been excluded. We placed the patients into two groups: (1) patients using 1 AED, and (2) patients using 2 AEDs. Clinical characteristics were then collected from the medical records.
  
  
  RESULTS
  Of the 57 patients, 41 (72%) were successfully treated with 1 AED, and 16 (28%) required 2 AEDs to control seizures. Multiple logistic regression analysis indicated that seizure onset prior to age 5 (odds ratio [OR]: 5.65, 95% confidence interval [CI]: 1.41-22.68) and history of febrile seizures (OR: 4.97, 95% CI: 1.06-23.36) were independent risk factors for poor response to initial therapy (p<0.05). Response to AEDs was not associated with the presence of focal slowing or generalized epileptiform discharges on EEG, abnormalities on MRI of the brain, frequency of afebrile seizures before drug therapy, or family history of febrile seizures or epilepsy.
  
  
  CONCLUSIONS
  This study revealed that 28% of patients with BCECTS experienced poor responses to initial AED therapy. Factors predicting poor response to the initial AED included onset of seizures prior to age 5 and history of febrile seizures.
authors.affiliation: Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
authors.forename: Yoon Kyoung
authors.initials: YK
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
authors.forename: So-Hee
authors.initials: SH
authors.lastname: Eun
authors.affiliation: Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
authors.forename: Baik-Lin
authors.initials: BL
authors.lastname: Eun
authors.affiliation: Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jung Hye
authors.initials: JH
authors.lastname: Byeon
keywords: Benign childhood epilepsy with centrotemporal spikes; Febrile seizures; Prognosis; Treatment
references.citation: Brain Dev. 1992 Jul;14(4):230-4
references.pmid: 1443401
references.citation: Neurology. 1997 Feb;48(2):430-7
references.pmid: 9040734
references.citation: Brain Dev. 2007 Jan;29(1):13-8
references.pmid: 16806777
references.citation: Eur J Paediatr Neurol. 2013 Sep;17(5):507-14
references.pmid: 23642492
references.citation: Epileptic Disord. 2006 Dec;8(4):285-8
references.pmid: 17150442
references.citation: Brain Dev. 2015 Jan;37(1):66-70
references.pmid: 24657010
references.citation: J Child Neurol. 2002 Jan;17(1):17-9
references.pmid: 11913563
references.citation: Brain Dev. 2007 Jun;29(5):281-4
references.pmid: 17055681
references.citation: Epileptic Disord. 2007 Dec;9(4):353-412
references.pmid: 18077226
references.citation: Arch Dis Child. 2015 Jan;100(1):62-7
references.pmid: 25202134
references.citation: Rev Neurol. 2009 Dec 1-15;49(11):581-6
references.pmid: 19921623
references.citation: J Formos Med Assoc. 2011 Mar;110(3):134-44
references.pmid: 21497276
references.citation: J Clin Neurophysiol. 2012 Oct;29(5):425-40
references.pmid: 23027100
references.citation: Neurologia. 2012 May;27(4):212-5
references.pmid: 21893369
references.citation: Brain. 2008 Sep;131(Pt 9):2264-86
references.pmid: 18718967
references.citation: J Child Neurol. 2008 Jul;23(7):785-90
references.pmid: 18658078