In daily clinical practice, doctors are frequently confronted with the issue whether treatment is necessary when the patient is without (further) seizures, but nevertheless still shows interictal discharges on the EEG. Will these discharges influence cognition temporarily and in time correlated with the discharges or is there a longer-lasting or even cumulative impairment? Which children are most at risk and when? Based on available literature in this field and own research in patients with Benign Epilepsy with Centro-Temporal spikes (BECTS), an inventory has been made of all issues that has to be addressed to answer these crucial questions. Prospective studies in drug naïve children with BECTS (with or without behavioral comorbidity) are highly recommended.