Is there a rationale for treating interictal epileptic discharges in self-limiting epilepsy with centrotemporal spikes (SeLECTS)?

The impact of epilepsy on the quality of life of affected children and their families is dominated by other factors than the seizures. The cognitive and behavioral features of the condition are most relevant. It has long been speculated that there might be a connection between the occurrence of interictal epileptiform discharges (IEDs) and neuropsychological symptoms. The IEDs are known to respond well to treatment with anti-seizure medications (ASMs). Thus, the question of whether or not to treat children in situations in which the seizure load alone would not justify a medication is frequently re-occurring. This article presents an overview of the current literature on the topic and the implications for treatment decisions.