A 6-year-old boy is brought with 3 months of brief episodes during sleep where he wakes up with facial twitching, drooling, and inability to speak lasting under a minute. He remains conscious throughout. EEG shows centrotemporal spikes activated by sleep. Intelligence is normal. What is the characteristic feature that distinguishes this condition?
- A Progression to generalized tonic-clonic seizures in most cases
- B Spontaneous remission by adolescence in most cases ✓
- C Association with intellectual disability
- D Requirement of lifelong antiepileptic therapy
Correct answer: B. Spontaneous remission by adolescence in most cases
Explanation
Benign epilepsy with centrotemporal spikes (BECTS, Rolandic epilepsy) is characterized by focal aware seizures with facial symptoms and speech arrest during sleep, centrotemporal spikes on EEG, normal neuroimaging, and normal intellect. It is age-dependent and remits spontaneously by age 15 to 16 in over 98 percent of cases, even without treatment. Antiepileptic drugs are used only if seizures are frequent or distressing.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.