Electroclinical Effect of Steroid in Patients With Benign Childhood Epilepsy With Centrotemporal Spikes

NCT ID: NCT03490487

Last Updated: 2020-08-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-06-20

Study Completion Date

2020-12-25

Brief Summary

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Benign epilepsy with centro-temporal spikes is the most common type of focal epilepsy in children. It is known to be age-dependent and presumably genetic. Age of onset ranges from one to fourteen years and it represents fifteen percent to twenty five percent of epilepsy in children under 15 years of age.

Detailed Description

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Generally, Benign epilepsy with centro-temporal spikes is characterized by infrequent focal sensorimotor seizures in the face during sleep, which may secondarily generalize, along with spike-wave discharges, reflecting nonlesional cortical excitability from rolandic regions.

The prognosis is usually considered to be excellent. Over the past years, however, some investigators have questioned whether Benign epilepsy with centro-temporal spikes is indeed benign, considering the variety of different presentations associated with the disorder.It is not uncommon for Benign epilepsy with centro-temporal spikes to be associated with neuropsychological deficits, such as linguistic, cognitive, and behavioral impairment. In particular, reading difficulties and speech/language disorders are more common in children with Benign epilepsy with centro-temporal spikes than in healthy controls.Various neuropsychological deficits seem to be very dependent on the spike index, as well as the predominant localization of epileptiform discharges.Furthermore, the frequency of epileptiform discharges is closely related not only to the degree of neuropsychological deficits, but also to an atypical evolution of benign epilepsy with centro-temporal spikes.

The high comorbid prevalence of attention deficit hyperactivity disorder and epilepsy suggests that there is a bidirectional relationship between these disorders .Cognitive impairment and attention problems are particularly crucial issues in children with epilepsy who are in a vigorous phase of neurodevelopment.

Resolution of continuous spike-and-wave during sleep had been achieved with conventional antiepileptic drugs including ethosuximide, valproic acid, levetiracetam, and sulthiame. When these agents fail to normalize the EEG, a trial with second-line agents such as steroids or high-dose diazepam is attempted.

Conditions

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Benign Childhood Epilepsy With Centrotemporal Spikes

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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A antiepileptic

will receive conventional antiepileptic drugs only

Group Type ACTIVE_COMPARATOR

conventional antiepileptic drugs

Intervention Type DRUG

will receive conventional antiepileptic drugs only. EEG, attention deficit hyperactivity disorder test and intelligence quotient will be done before and 3 months after treatment.

B steroid

will receive oral steroid for 3 months beside conventional antiepileptic drugs

Group Type EXPERIMENTAL

conventional antiepileptic drugs

Intervention Type DRUG

will receive conventional antiepileptic drugs only. EEG, attention deficit hyperactivity disorder test and intelligence quotient will be done before and 3 months after treatment.

oral steroid

Intervention Type DRUG

will receive oral steroid for 3 months beside conventional antiepileptic drugs. EEG, attention deficit hyperactivity disorder test and intelligence quotient will be done before and 3 months after treatment.

Interventions

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conventional antiepileptic drugs

will receive conventional antiepileptic drugs only. EEG, attention deficit hyperactivity disorder test and intelligence quotient will be done before and 3 months after treatment.

Intervention Type DRUG

oral steroid

will receive oral steroid for 3 months beside conventional antiepileptic drugs. EEG, attention deficit hyperactivity disorder test and intelligence quotient will be done before and 3 months after treatment.

Intervention Type DRUG

Other Intervention Names

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carbamazepine, valproate, oxcarbazepine or levetiracetam Prednisolone

Eligibility Criteria

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Inclusion Criteria

* History and EEG findings of benign epilepsy with centrotemporal spikes

Exclusion Criteria

* Genetic disorders.
* Metabolic or neurodegenerative disease.
* Gross motor delay.
Minimum Eligible Age

3 Years

Maximum Eligible Age

14 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Khalaf A Sayed

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gamal A Abdelal, MD

Role: STUDY_DIRECTOR

Assiut University

Locations

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Assiut university

Asyut, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Gamal A Abdelal, MD

Role: CONTACT

+201111686162

Nafisa H Rifaat, MD

Role: CONTACT

+201003472082

References

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Fejerman N, Caraballo R, Tenembaum SN. [Atypical evolutions of benign partial epilepsy of infancy with centro-temporal spikes]. Rev Neurol. 2000 Aug 16-31;31(4):389-96. Spanish.

Reference Type BACKGROUND
PMID: 11008297 (View on PubMed)

Ay Y, Gokben S, Serdaroglu G, Polat M, Tosun A, Tekgul H, Solak U, Kesikci H. Neuropsychologic impairment in children with rolandic epilepsy. Pediatr Neurol. 2009 Nov;41(5):359-63. doi: 10.1016/j.pediatrneurol.2009.05.013.

Reference Type BACKGROUND
PMID: 19818938 (View on PubMed)

Danielsson J, Petermann F. Cognitive deficits in children with benign rolandic epilepsy of childhood or rolandic discharges: a study of children between 4 and 7 years of age with and without seizures compared with healthy controls. Epilepsy Behav. 2009 Dec;16(4):646-51. doi: 10.1016/j.yebeh.2009.08.012. Epub 2009 Oct 29.

Reference Type BACKGROUND
PMID: 19879197 (View on PubMed)

Clarke T, Strug LJ, Murphy PL, Bali B, Carvalho J, Foster S, Tremont G, Gagnon BR, Dorta N, Pal DK. High risk of reading disability and speech sound disorder in rolandic epilepsy families: case-control study. Epilepsia. 2007 Dec;48(12):2258-65. doi: 10.1111/j.1528-1167.2007.01276.x. Epub 2007 Sep 10.

Reference Type BACKGROUND
PMID: 17850323 (View on PubMed)

Kanemura H, Sano F, Aoyagi K, Sugita K, Aihara M. Do sequential EEG changes predict atypical clinical features in rolandic epilepsy? Dev Med Child Neurol. 2012 Oct;54(10):912-7. doi: 10.1111/j.1469-8749.2012.04358.x. Epub 2012 Jul 4.

Reference Type BACKGROUND
PMID: 22759211 (View on PubMed)

Kwon S, Hwang TG, Lee J, Kim DK, Seo HE. Benign childhood epilepsy with centrotemporal spikes: to treat or not to treat. J Epilepsy Res. 2013 Jun 30;3(1):1-6. doi: 10.14581/jer.13001. eCollection 2013 Jun.

Reference Type BACKGROUND
PMID: 24649464 (View on PubMed)

Kwon S, Seo HE, Hwang SK. Cognitive and other neuropsychological profiles in children with newly diagnosed benign rolandic epilepsy. Korean J Pediatr. 2012 Oct;55(10):383-7. doi: 10.3345/kjp.2012.55.10.383. Epub 2012 Oct 29.

Reference Type BACKGROUND
PMID: 23133485 (View on PubMed)

Inutsuka M, Kobayashi K, Oka M, Hattori J, Ohtsuka Y. Treatment of epilepsy with electrical status epilepticus during slow sleep and its related disorders. Brain Dev. 2006 Jun;28(5):281-6. doi: 10.1016/j.braindev.2005.09.004. Epub 2006 Jan 10.

Reference Type BACKGROUND
PMID: 16376508 (View on PubMed)

Kramer U, Sagi L, Goldberg-Stern H, Zelnik N, Nissenkorn A, Ben-Zeev B. Clinical spectrum and medical treatment of children with electrical status epilepticus in sleep (ESES). Epilepsia. 2009 Jun;50(6):1517-24. doi: 10.1111/j.1528-1167.2008.01891.x. Epub 2008 Nov 19.

Reference Type BACKGROUND
PMID: 19054417 (View on PubMed)

Guerrini R, Genton P, Bureau M, Parmeggiani A, Salas-Puig X, Santucci M, Bonanni P, Ambrosetto G, Dravet C. Multilobar polymicrogyria, intractable drop attack seizures, and sleep-related electrical status epilepticus. Neurology. 1998 Aug;51(2):504-12. doi: 10.1212/wnl.51.2.504.

Reference Type BACKGROUND
PMID: 9710026 (View on PubMed)

Scheltens-de Boer M. Guidelines for EEG in encephalopathy related to ESES/CSWS in children. Epilepsia. 2009 Aug;50 Suppl 7:13-7. doi: 10.1111/j.1528-1167.2009.02211.x.

Reference Type BACKGROUND
PMID: 19682043 (View on PubMed)

Chou IC, Chang YT, Chin ZN, Muo CH, Sung FC, Kuo HT, Tsai CH, Kao CH. Correlation between epilepsy and attention deficit hyperactivity disorder: a population-based cohort study. PLoS One. 2013;8(3):e57926. doi: 10.1371/journal.pone.0057926. Epub 2013 Mar 6.

Reference Type BACKGROUND
PMID: 23483944 (View on PubMed)

Other Identifiers

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DS

Identifier Type: -

Identifier Source: org_study_id

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