Transcranial Magnetic Stimulation for BECTS
Transcranial Magnetic Stimulation for BECTS
Benign epilepsy with centrotemporal spikes (BECTS) is the most common pediatric epilepsy
 syndrome. Affected children typically have a mild seizure disorder, but yet have moderate
 difficulties with language, learning and attention that impact quality of life more than the
 seizures. Separate from the seizures, these children have very frequent abnormal activity in
 their brain known as interictal epileptiform discharges (IEDs, or spikes), which physicians
 currently do not treat. These IEDs arise near the motor cortex, a region in the brain that
 controls movement.

 In this study, the investigators will use a form of non-invasive brain stimulation called
 transcranial magnetic stimulation (TMS) to determine the impact of IEDs on brain regions
 important for language to investigate: (1) if treatment of IEDs could improve language; and
 (2) if brain stimulation may be a treatment option for children with epilepsy.

 Participating children will wear electroencephalogram (EEG) caps to measure brain activity.
 The investigators will use TMS to stimulate the brain region where the IEDs originate to
 measure how this region is connected to other brain regions. Children will then receive a
 special form of TMS called repetitive TMS (rTMS) that briefly reduces brain excitability. The
 study will measure if IEDs decrease and if brain connectivity changes after rTMS is applied.

 The investigators hypothesize that the IEDs cause language problems by increasing
 connectivity between the motor cortex and language regions. The investigators further
 hypothesize that rTMS will reduce the frequency of IEDs and also reduce connectivity between
 the motor and language region
Inclusion Criteria:

 -  A diagnosis of Benign Epilepsy with Centrotemporal Spikes (BECTS), sometimes called
 Rolandic Epilepsy. Diagnosis will be based on a history of a focal motor seizure
 (affecting the face or causing hypersalivation) or a history of a seizure out of sleep
 AND an EEG with unilateral or bilateral centrotemporal spike waves.

 -  English-speaking

 Exclusion Criteria:

 -  History of prematurity < 35 weeks gestational age;

 -  History of serious neurologic problems (i.e. history of other seizure disorder other
 than simple febrile seizure, head trauma with prolonged loss of consciousness,
 cerebrovascular accident or neuro-inflammatory disease)

 -  Focal deficits on neurologic exam

 -  History of abnormal MRI (with clear gray or white matter abnormality)