Benign Rolandic Epilepsy

Patient/Family Story

We heard a thud from Timmy's room one night. We rushed in and saw him on the floor, having a whole body seizure. The next day, the pediatrician asked if Timmy had ever had any tingling or jerking movements in his face or body. We were shocked when Timmy said yes, sometimes his tongue would tingle or his cheek would jerk for a little while. The doctor did an EEG and said it was "Rolandic epilepsy", and that Timmy didn't have to be treated. That's what we wanted to hear. He had one other, milder seizure a few months later. He ran into our room and woke us up. He couldn’t talk because the side of his mouth was twitching and he was drooling. Fortunately, it was over quickly. It's been 5 years now, and except for a few tingles and twitches that occur during sleep, Timmy has been doing great.

What is Benign Rolandic Epilepsy?

Benign rolandic (sylvian) epilepsy (also called BECTS, benign epilepsy of childhood with centrotemporal spikes) is a common childhood seizure syndrome, with seizures beginning between 2 and 13 years of age. A hereditary factor is often present. The seizures most commonly observed in BRE are partial motor seizures (twitching) or a sensory seizure (numbness or tingling sensation) involving the face or tongue and which may cause garbled speech. In addition, tonic-clonic seizures may occur, especially during sleep. Although the seizures are often infrequent, or may occur in infrequent clusters, some patients need medication. These include children who, in addition to the typical seizure disorder, have daytime seizures, a learning disorder, a mild mental handicap, or multiple seizures at night, which leave the child lethargic in the morning.

How is Benign Rolandic Epilepsy Diagnosed?

The EEG shows a characteristic pattern of abnormal spikes over the central and temporal regions of the brain, especially during sleep. Despite the abundant abnormal spike activity, the child may have only one or a few seizures. This illustrates that the amount or frequency of abnormal spike activity in the EEG is not necessarily related to the severity of the epileptic disorder. Siblings or close relatives may have the same EEG pattern during childhood without ever having seizures.

How is Benign Rolandic Epilepsy Treated?

The seizures are usually easily controlled with low to moderate doses of carbamazepine, oxcarbazepine, or gabapentin (or, outside the United States, clobazam). The drug is usually continued until age 15, when the seizures spontaneously stop in almost all patients.