Neurobehavioral Prognosis Of Children With Benign Childhood Epilepsy With Centrotemporal Spikes After Remission

Objective : Benign Childhood Epilepsy With Centrotemporal Spikes(BECT)is a common epilepsy syndrome in childhood.BECT is a type of epilepsy that is age-related and disappears gradually with age.The reason is unclear,there may be a genetic predisposition.It is closely related to sleep and has a special seizure pattern.The electroencephalogram shows localized discharge in the central and temporal regions.Before 2010,domestic and foreign scholars believed that BECT is a kind of benign,self-limiting epilepsy,with no obvious abnormalities in psychomotor development,and no sequelae left after the seizure stopped.In recent years,a large number of neuropsychological studies have found that children with BECT have varying degrees of neuropsychological impairment in reading,language,emotion,executive function and attention during the onset,which affects the children’s academic performance and social function.We have used the ANT tool to study the attention function of newly diagnosed BECT patients in the early stage,and found that the newly diagnosed BECT patients have obvious attention function impairment,and the younger the onset age,the more serious the attention network dysfunction.However,it is not clear whether there are still the characteristics of attention dysfunction,attention dysfunction and related factors of attention dysfunction after remission.Whether the cognitive impairment of BECT patients continues until after BECT is relieved,and what is the social outcome after BECT is completely relieved,the results of the current study are not uniform.This study will conduct neuropsychological tests and social outcome surveys on BECT patients after complete remission,to explore whether there are still neuropsychological damage,neuropsychological damage characteristics and related factors of attention dysfunction in BECT patients after remission,and to understand the social outcome after remission.Methods : Thirty BECT patients over 16 years old and without seizures over two years(BECT group;21 males,9 females,median age 17 years)in the Department of Neurology,Provincial Children’s Hospital Affiliated to Anhui Medical University from January 1,2009 to December 31,2010 and 42 healthy controls(control group;30 males,12 females,median age 17 years)were tested by the attention network test tool and Montreal cognitive assessment.Results: All subjects in the BECT group and the control group had a MoCA score ≥26points.There was no significant difference in overall MoCA score between BECT group and control group(28(27,29)vs 28(27,28),Z=-0.140,P=0.889).There was no statistically significant difference in visual space and executive function(28(27,29)vs28(27,28),Z=-0.140,P=0.889),naming(3(2.75,3)vs 3(2,3),Z=-0.707.P=0.480),attention(5.5(5,6)vs 6(5,6),Z=-0.364,P=0.716),language(3(2.75,3)vs 3(2,3),Z=-1.117,P=0.264),abstract thinking(2(2,2)vs 2(2,2),Z=-0.252,P=0.801),delayed recall(4(4,5)vs 4(4,5),Z=-0.751,P=0.452)and orientation(6(5,6)vs 6(6,6),Z=-0.512,P=0.608)scores compared with the control group.There was not statistically significant difference in the accuracy rate and total reaction time of attention network test between the BECT group and the control group(97.0(95.0,99.0)% vs 98.0(95.5,98.0)%,Z=-0.437,P=0.662;587.50(523.50,668.75)ms vs(610.00(584.25,631.75)ms,Z=-0.320,P=0.749;respectively).And there was not statistically significant difference in the efficiency of the alert network,directional network,and executive control network in the BECT group compared with the control group((46.13±24.97)ms vs(48.52±27.65)ms,t=-0.376,P=0.708;(32.23±18.12)ms vs(33.21±19.68)ms,t=0.215,P=0.830;(124.50±39.87)ms vs(117.60±50.13)ms,t=0.626,P=0.533;respectively).Conclusion: In this research we found:1)After remission,there is no obvious damage to the naming,abstract thinking,language,attention,memory,visual space,orientation ability and delayed recall of BECT patients.2)BECT patients’ overall attention network function and its sub-networks(alert network,directional network,executive control network)function are not significantly damaged.3)BECT patients have a good social outcome and can integrate into society well.