Self-limited epilepsy with centrotemporal spikes

Self-limited epilepsy with centrotemporal spikes (SeLECTS), formerly known as benign epilepsy with centrotemporal spikes (BECTS) or benign rolandic epilepsy, is the most common focal epilepsy syndrome of childhood. It is characterized by focal seizures that originate from the rolandic (centrotemporal) region of the brain, which controls the face, mouth, and hand areas. The condition primarily affects the nervous system and has an excellent long-term prognosis, with seizures typically resolving spontaneously before adolescence. The hallmark seizures involve unilateral sensorimotor symptoms of the face, lips, tongue, and pharynx, often manifesting as tingling or numbness on one side of the mouth, drooling, difficulty speaking (speech arrest), and clonic jerking of the face or hand. Seizures frequently occur during sleep or upon awakening. The electroencephalogram (EEG) characteristically shows high-amplitude centrotemporal spikes that are activated by drowsiness and sleep. Some children may also experience secondary generalized tonic-clonic seizures, particularly during the night. Most children with SeLECTS have normal neurological development and intelligence, though some may experience mild, transient cognitive or language difficulties during the active phase of the epilepsy. Treatment is not always necessary given the self-limited nature of the condition. When seizures are frequent or disruptive, antiseizure medications such as carbamazepine, levetiracetam, or sulthiame may be used. The prognosis is generally excellent, with complete seizure remission typically occurring by age 15–16 years, and most children can eventually discontinue medication.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

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