Benign Rolandic Epilepsy
- Involves twitching, numbness or tingling of the child's face or tongue (a partial seizure).
- Seizures last no more than 2 minutes.
- Child remains fully conscious.
- The syndrome represents about 15 percent of all epilepsies in children.
- Because the seizures may be infrequent and usually occur at night, many children do not take medication.
- In almost every case, the seizures stop on their own by age 15.
What is it like? A typical attack involves twitching, numbness, or tingling of the child's face or tongue (a partial seizure), which often interferes with speech and may cause drooling. These seizures last no more than 2 minutes and the child remains fully conscious. Sometimes the child also may have tonic-clonic seizures, usually during sleep. The seizures are usually infrequent, but they may occur in widely spaced clusters.
The name derives from the rolandic area of the brain, which is the part that controls movements. As noted below, “benign” does not refer to the degree of intensity of the seizures but of the universal tendency to outgrow having seizures. The official modern name is “benign epilepsy with centro-temporal spikes” or BECTS.
Who gets it? This syndrome represents about 15% of all epilepsies in children. The seizures begin at an average age of about 6 to 8 years (range 3-13) and are a bit more likely to affect boys. The children generally have normal intelligence, which is not affected by the seizures. The syndrome is more common in children who have close relatives with epilepsy.
Tell me more: Other tests, such as the neurologic examination and MRI (if performed), are normal. Some children will have learning difficulties and behavioral problems during the period of time that they have seizures. The problems typically disappear once the seizures stop and the EEG reverts to normal.
How is it treated? Because the seizures may be infrequent and usually occur at night, many children do not take any seizure medicines for BRE. Medication may be prescribed if a child has daytime seizures, a learning disorder, a mild mental handicap, or frequent seizures during sleep. The seizures usually can be controlled by any of the common seizure medicines. Neurontin (gabapentin), Trileptal (oxcarbazepine), Tegretol or Carbatrol (carbamazepine), Keppra (levetiracetam) or Vimpat (lacosamide) are most often prescribed in the United States.
What's the outlook? In almost every case, the seizures stop on their own by age 15.
Authored by: Gregory L. Holmes, MD | Robert S. Fisher, MD, PhD on 9/2013
Reviewed by: Robert S. Fisher, MD, PhD on 10/2013