Introduction. Patients who have a benign epilepsy with centrotemporal spikes (BECTS) have a good prognosis for seizure control, but few data exist on the long-term outcome of associated cognitive and behavioral disturbances.
Objectives. To study long-term prognosis with regard to seizure and neuropsychological outcome and social success.
Material and methods. The patient series comprised 24 (10%) of 230 children who had active epilepsy between 1961 and 1964 in Finland. Seventeen (74%) of 23 patients with BECTS were followed up to 2002. The mean duration of follow-up was 42 years (range 38–53, median 40). Their social outcome was compared with that of general population controls matched for age, gender and domicile in 1992.
Results. All patients entered one-year remission during the mean follow-up of 5 years (mean 2.76, SD 1.03, median 2, range 2–5) and five-year remission on the mean follow-up of 9.18 years (SD 2.38, median 10, range 5–13). The number of children was among subjects with BECTS significantly lower than than that of controls. The check-up of reproductive activity on 25-year follow-up showed that the patients had one or more children in significantly fewer cases than controls (59% vs. 83%, p = 0.0222).
Conclusions. The long-term evolution of BECTS is characterized by spontaneous recovery in adolescence with no increased seizure susceptibility in adulthood. The very long-term prognosis for social competence and success is excellent.