Focal epileptic EEG discharges in children not suffering from clinical epilepsy: etiology, clinical significance, and management.

Epileptic discharges in the EEG record may be found in children not suffering from convulsive seizures. Such discharges often consist of spiking in the rolandic and midtemporal areas (labelled centrotemporal spikes) and less often in the occipital region. They may be multifocal. These focal discharges seem to be age-dependent, tending to disappear during the teenage years. Children displaying such discharges are discovered either through large-scale EEG studies of asymptomatic children or among those who are referred for EEG because of various nonrelated complaints such as headaches, bed-wetting, syncope, behaviour problems, and learning difficulties. Many of them are labelled as suffering from "masked epilepsy" and are considered as epileptics. One hundred such cases are reviewed, and the clinical and EEG data are analysed. Three illustrative case reports are presented, and the literature is critically reviewed. It is maintained that these children are not to be considered as epileptic and should not be treated with anticonvulsant drugs.