Cognitive Assessments in Benign Childhood Epilepsies

Benign childhood epilepsies, notably benign epilepsy with centrotemporal spikes (BECTS) and related self-limited focal syndromes, have traditionally been regarded as disorders with favourable prognoses and minimal lasting neurological impact. However, growing evidence underscores subtle but meaningful impairments in domains such as attention, language, memory and executive function. Comprehensive cognitive assessment in these children has evolved from simple intelligence screening towards multidimensional profiles incorporating behavioural, neurophysiological and neuroimaging markers. Standardised tools—such as the Wechsler Intelligence Scale for Children, phonological awareness tests and computerised auditory processing batteries—have been complemented by advanced techniques including magnetoencephalography (MEG) and diffusion tensor imaging. These approaches reveal that even in the absence of overt developmental delay, interictal epileptic spikes and network disorganisation can disrupt the maturation of cortical circuits underlying language and memory. Early identification of at-risk profiles enables tailored interventions, such as cognitive remediation or educational support, and informs parental counselling. The global significance of this work lies in refining the benign label to encompass a spectrum of subtle neuropsychological challenges, thereby promoting more nuanced clinical management and long-term monitoring of cognitive development in affected children.

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Cognitive Assessments in Benign Childhood Epilepsies publication trend

The graph below shows the total number of articles in cognitive assessments in benign childhood epilepsies across all publications each year (not limited to Nature Index journals).

Technical terms

Benign epilepsy with centrotemporal spikes (BECTS): A self-limited focal epilepsy syndrome in childhood characterised by nocturnal seizures and characteristic EEG discharges over the rolandic regions.

Functional connectivity: Statistical associations between activity in different brain regions, often inferred from MEG, EEG or fMRI data.

Magnetoencephalography (MEG): A non-invasive technique that records magnetic fields generated by neuronal currents, providing millisecond-scale temporal resolution of brain activity.

Interictal epileptic spikes (IES): Transient, abnormal EEG discharges occurring between clinical seizures, associated with transient network disruption.

Graph theory parameters: Network metrics such as clustering coefficient (extent of local connectivity) and path length (average shortest path between nodes), used to quantify brain network organisation.

Phonological awareness: The ability to recognise and manipulate sound structures in language, essential for reading and verbal learning.

References

1. Temporal Auditory Processing and Phonological Awareness in Children with Benign Epilepsy with Centrotemporal Spikes. BioMed Research International (2015).
2. Reduced Structural Connectivity between Sensorimotor and Language Areas in Rolandic Epilepsy. PLOS ONE (2013).
3. Functional and Structural Network Disorganizations in Typical Epilepsy With Centro-Temporal Spikes and Impact on Cognitive Neurodevelopment. Frontiers in Neurology (2019).