Childhood Epilepsy with Centrotemporal Spikes (CECTS)

Childhood epilepsy with centrotemporal spikes (CECTS) was previously known as benign epilepsy with centrotemporal spikes (BECTS). CECTS is an idiopathic age-related epileptic syndrome diagnosed by a combination of the clinical picture and EEG findings. It is possibly the most common epilepsy syndrome that occurs in typical children and is probably genetic. It typically occurs in children 2-13 years of age, although most commonly between ages 4 -11.

Other Names

Benign epilepsy with centrotemporal spikes (BECTS)
Benign rolandic epilepsy (BRE)

Key Points

Refer for neuropsychological testing
Children with CECTS may have cognitive differences in many areas and should be referred early for psychological/neuropsychological testing. [Wickens: 2017] [Cheng: 2017]
SUDEP
Sudden death with epilepsy (SUDEP), although rare, has been observed. [Doumlele: 2017] Clinicians should discuss mortality risk when making treatment decisions. For more details, see SUDEP (Sudden Death with Epilepsy).
Clinical assessment
A typical clinical picture and EEG in a child with normal development and neurological exam does not warrant further investigation. Anything atypical should prompt further investigation.

Diagnosis of CECTS

The EEG typically shows high-voltage centrotemporal spikes (unilateral or bilateral) that may be followed by a slow wave and are activated in drowsiness and sleep; EEG changes may be present without clinical seizures in these patients. CECTS may be more common in boys than girls.

Prognosis

Remission occurs in the majority of individuals. There are no neurologic precursors or sequelae, although these patients may have learning differences and cognitive difficulties. [Wickens: 2017] [Cheng: 2017]

Presentation

Features of the seizures that occur as a part of CECTS:
  • Brief, simple partial seizures with associated somatosensory symptoms that often spread, sometimes in the typical “Jacksonian march” or generalize into tonic-clonic seizures
  • Occur mostly at night (50-81%), although in some, during sleep and awake states (5-40%) or only while awake (0-32%)
  • Occur infrequently
  • Show unilateral somatosensory involvement, often of the tongue
  • Interrupt speech
  • May lead to pooling of saliva and gurgling noises (ask specifically about these symptoms)
  • Do not cause confusion or amnesia

Treatment & Management of CECTS

If seizures are infrequent and the family is comfortable, the patient may not need antiepileptic drug treatment. Although CECTS may be associated with status epilepticus, treatment does not necessarily alter this possibility. Most patients stop having seizures by adolescence. Although SUDEP (sudden unexpected death in epilepsy) is a very rare outcome in CECTS, clinicians should discuss mortality risk when making treatment decisions. [Doumlele: 2017]

ICD-10 Coding

G40.0, Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset
G40.0 requires further codes that contain a greater level of detail are needed. These can be found at Epilepsy and Recurrent Seizures (icd10.com).

Resources

Information & Support

Related Portal Content
Assessment and management information for the primary care clinician caring for the child with seizures: Answers to questions frequently asked by families with a child diagnosed with seizures: Families may also benefit from:

For Professionals

Epilepsy Foundation
A national organization that provides information about epilepsy; programs to improve epilepsy treatment; materials to assist in helping people with epilepsy find jobs; activities in schools to educate the public; activities to educate policymakers; funds for research; links to find local and state resources; and news about conferences and other items of interest.

Services for Patients & Families Nationwide (NW)

For services not listed above, browse our Services categories or search our database.

* number of provider listings may vary by how states categorize services, whether providers are listed by organization or individual, how services are organized in the state, and other factors; Nationwide (NW) providers are generally limited to web-based services, provider locator services, and organizations that serve children from across the nation.

Authors & Reviewers

Initial publication: June 2011; last update/revision: December 2022
Current Authors and Reviewers:
Author: Lynne M. Kerr, MD, PhD
Reviewer: Cristina Corina Trandafir, MD, PhD
Authoring history
2019: update: Lynne M. Kerr, MD, PhDA
2011: first version: Lynne M. Kerr, MD, PhDA; Denise Morita, MDA
AAuthor; CAContributing Author; SASenior Author; RReviewer

Page Bibliography

Cheng D, Yan X, Gao Z, Xu K, Zhou X, Chen Q.
Common and Distinctive Patterns of Cognitive Dysfunction in Children With Benign Epilepsy Syndromes.
Pediatr Neurol. 2017;72:36-41.e1. PubMed abstract

Doumlele K, Friedman D, Buchhalter J, Donner EJ, Louik J, Devinsky O.
Sudden Unexpected Death in Epilepsy Among Patients With Benign Childhood Epilepsy With Centrotemporal Spikes.
JAMA Neurol. 2017;74(6):645-649. PubMed abstract / Full Text

Wickens S, Bowden SC, D'Souza W.
Cognitive functioning in children with self-limited epilepsy with centrotemporal spikes: A systematic review and meta-analysis.
Epilepsia. 2017;58(10):1673-1685. PubMed abstract