This information is for people affected by or concerned about self-limited epilepsy with centrotemporal spikes (SeLECTS), including parents and carers. On this page we talk about how SeLECTS is diagnosed, what causes it, symptoms, treatment options and long-term outlook.
Use this page as a general guide and speak to a health professional for more information and support.
On this page
What is self-limited epilepsy with centro-temporal spikes
Self-limited epilepsy with centrotemporal spikes (SeLECTS), previously known as benign rolandic epilepsy, is one of the most common types of childhood epilepsy. It affects about six in every 100,000 children per year.
SeLECTS usually starts in children between the ages of four and 10 years. It affects slightly more boys than girls and usually stops during their teens.
What causes self-limited epilepsy with centrotemporal spikes?
It’s unclear exactly what causes SeLECTS, but the child’s genetics may play a part. Close family members, such as a parent or grandparent may also have had this type of epilepsy when they were children.
What are the signs and symptoms of self-limited epilepsy with centrotemporal spikes?
Children with SeLECTS usually have focal onset seizures, which start in one side of the brain and affect the mouth and face.
Seizures usually happen at night or soon after waking up. Seizures can cause dribbling, gurgling or difficulty speaking. Most children with SeLECTS have fewer than ten seizures in their lifetime.
Even though focal onset seizures are the most common type of seizure in children who have SeLECTS, sometimes, they may change into tonic-clonic seizures. A child having this type of seizure may fall unconscious, become stiff and make jerking movements with their arms and legs.
Unlike other types of epilepsy, children with SeLECTS are generally well and do not experience any major learning difficulties. But, some children with SeLECTS may have mild learning difficulties, such as difficulties with reading and language, co-ordination, attention and behaviour.
How is self-limited epilepsy with centrotemporal spikes diagnosed?
If you think a child has epilepsy, including SeLECTS, contact their doctor. You may be referred to a paediatrician (a doctor who specialises in child health).
Diagnosis is usually based on a description of the seizures and sometimes an EEG (electroencephalogram) test is carried out. An EEG is a painless test that uses small sensors attached to the scalp to pick up the electrical signals produced by the brain.
Further tests, such as blood tests or MRI (magnetic resonance imaging) scans of the brain are not normally needed to diagnose SeLECTS. But if they are, a health professional will explain them to you.
Treatment for self-limited epilepsy with centrotemporal spikes
Epilepsy specialists involved in the care of a child with SeLECTS should discuss with them, and their parents or carers, the treatment options available and if treatment is needed. Not all children with SeLECTS will need to take anti-seizure medication.
When deciding if treatment is suitable for a child with SeLECTS, a health professional should talk to you about:
- how often seizures occur and how severe they are
- the possible risks of continuing seizures
- the possible side effects of treatment.
If you decide that treatment is suitable, the doctor should offer you one of the following first treatment options:
- Lamotrigine (also known as Lamictal) – a medicine that comes as a tablet, that you swallow.
- Levetiracetam (also known as Keppra) – a medicine that comes as a tablet, liquid or granules, that you swallow.
If one of these treatment options is tried first, and does not work, the other one can be tried afterwards. It does not matter what order the child tries them in.
If the first treatment options do not work, then the doctor may suggest trying one of the following treatment options:
- Carbamazepine (also known as Tegretol) – a medicine that comes as a tablet, that you swallow.
- Oxcarbazepine (also known as Trileptal) – a medicine that comes as a tablet, that you swallow.
- Zonisamide (also known as Zonegran) – a medicine that comes as a capsule, that you swallow.
Each of these medicines can be tried on their own to see if they work. If none of them work, then sulthiame (also known as sultiame) can be tried on its own or as an add-on treatment. Sulthiame is a medicine that comes as a tablet that you swallow.
Talk to a doctor if you’re not sure which medicines a child with SeLECTS should be taking. They will help to answer any questions that you have, including about the dose and how often each medicine should be taken.
All medicines come with a risk of side effects. Before starting any treatment it’s important to understand the possible side effects. The specialists involved in your child’s care should talk to you about the risks and benefits of the different treatment options.
In a small number of children with SeLECTS, the anti-seizure medications carbamazepine, oxcarbazepine and lamotrigine may:
- make seizures worse
- cause another epilepsy syndrome to develop
- affect cognitive performance (mental processes involved in knowing, learning and understanding).
For some children taking anti-seizure medication for SeLECTS, there may be a slight change in their performance at school. If you’re concerned about this, talk to the doctor involved in their care. They may offer the following:
- A sleep EEG to rule out status epilepticus – a type of seizure that lasts a longer time than usual.
- An assessment to review their academic performance.
Follow-up care
A child with SeLECTS should have follow-up care tailored to their needs. This may be slightly different for everyone.
For some children, it may be possible to stop anti-seizure medication altogether if they have not had any seizures for at least two years or when they reach the age of 14.
What’s the long-term outlook for people with self-limited epilepsy with centrotemporal spikes?
The long-term outlook for people with SeLECTS is generally very good. Most children with SeLECTS completely stop having seizures by the age of 16.
Living with self-limited epilepsy with centrotemporal spikes and getting support
Having a child with any form of epilepsy can be challenging and upsetting. Talk to the child’s doctor for help on how to support them well. And talk to your own doctor if you need support for yourself. If you’re caring for someone with SeLECTS, it’s important that you look after yourself and get any support you need.
You may find it helpful joining an in-person or online support group, where you can listen to or share experiences with other people who understand what you’re going through.
Other useful organisations
Epilepsy Action
A charity that provides support and information to people affected by epilepsy, including people affected SeLECTS.
