Childhood Epilepsy with Centro-Temporal Spikes (CECTS)

12th July 2021

Childhood Epilepsy with Centro-Temporal Spikes (CECTS) is one of the most commonly diagnosed epilepsy syndromes in children. In fact, as many as 1 in 5 children with epilepsy are diagnosed with CECTS. 

This particular syndrome affects males slightly more frequently than females and symptoms can start typically anywhere between the ages of 3 and 10 years old. At present, the cause of CECTS is currently unknown, although it’s believed to be caused by a genetic abnormality, researchers are yet to discover it. 

It’s common for other family members to have had this type of epilepsy when they were a child and occasionally family members may have a different type of epilepsy.

Symptoms

Focal seizures are the main symptom of CECTS and will commonly occur when the child is going to sleep or just as they’re waking up. Children with CECTS report a tingling sensation, similar to pins and needles, on one side of their mouth, including the tongue, lips and cheek. 

The focal seizures only occur in one side of the brain, which explains why the sensation only takes place on one side of the mouth. In addition, a child’s speech may become difficult to understand. Gurgling noises are another common symptom that parents have reported when they discuss the symptoms with a doctor for the first time. 

Twitching and stiffness of one side of the mouth or face is seizure activity, and these movements can spread to other areas of the body, most likely the arm and the leg. 

Diagnosis

Diagnosis of CECTS will require a full history of symptoms and seizure activity, as well as an electroencephalogram (EEG) test to monitor electrical activity in the brain. It’s through the EEG test that a centro-temporal activity will be noticed, however, sometimes the EEG may appear normal, which may require a sleep-deprived EEG to confirm. This is because the centro-temporal activity may be more visible when the child is in a fatigued state. 

Brain scans, such as a Magnetic Resonance Imaging scan (MRI) will usually appear normal, which means they are rarely used to diagnose this particular syndrome. 

Treatment 

In many cases of CECTS, seizures will usually cease once the child starts puberty, which is why epilepsy medications are not always prescribed for this syndrome. Many children will only experience a handful of seizures per year and therefore will not require any treatment. If seizures are more frequent, or are tonic-clonic in nature then epilepsy medications include, carbamazepine, lamotrigine, levetiracetam or sodium valproate.

Prognosis

Almost every child who has CECTS will cease having seizures when they reach puberty, which is usually before their 16th birthday. Children with CECTS do not typically have any learning or behavioural difficulties as a result of the syndrome, although some may have difficulty with reading and language, which may mean that they need additional support, however most will cope well with school work. 

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