Rolandic Epilepsy Symptoms, Causes, and Further Details
Childhood Epilepsy: Understanding Benign Rolandic Epilepsy (BRE)
Childhood epilepsy, specifically Benign Rolandic Epilepsy (BRE), is a common condition that primarily affects children aged 4-14, with the highest incidence between 7-10 years. This condition is more prevalent in males [1].
BRE is characterised by focal seizures involving hemifacial sensorimotor symptoms, such as numbness, twitching, or tingling mainly around the lower lip and face, often associated with speech arrest and hypersalivation. Seizures typically occur at night, and the child remains conscious during episodes [1][5].
Common symptoms of BRE include hemifacial sensorimotor seizures starting around the lower lip, possibly spreading to the ipsilateral arm, drooling, and speech difficulties during seizures. Seizures are often infrequent and mostly nocturnal, with consciousness usually preserved during seizures [1][5].
While BRE is considered "benign" because children usually outgrow the condition by adulthood, it can occasionally cause learning difficulties and speech abnormalities in early onset cases, which resolve during adolescence [2].
Treatment options for BRE generally favour observation, as the syndrome is self-limited and often resolves spontaneously by adolescence without intervention. However, if seizures are frequent, occur during the day, or significantly disrupt sleep, a doctor may recommend medication [4][5].
Antiepileptic drugs (AEDs) such as ethosuximide, valproic acid, lamotrigine, and Neurontin (gabapentin) are commonly used for the treatment of childhood epilepsy, including BRE [3].
The prognosis for a child with BRE is very favourable. The syndrome typically remits by early adolescence (puberty), with less than 2% of affected children developing generalised seizures in adulthood [1]. EEG shows characteristic centrotemporal spikes, often more pronounced during sleep, but sleep architecture is not disrupted [1]. Neuroimaging is recommended to rule out structural abnormalities due to the focal EEG pattern [1].
On the other hand, Juvenile Myoclonic Epilepsy is a type of childhood epilepsy that typically begins in the teenage years and is considered a lifelong condition [6]. It is the most common generalised epilepsy syndrome. Children with this condition usually experience seizures within 1-2 hours of walking in the morning or after a nap, and the seizures consist of brief muscle jerks or tonic-clonic seizures [6].
In conclusion, childhood epilepsy with centrotemporal spikes (formerly BRE) is a benign, self-limited focal epilepsy syndrome with characteristic facial sensory-motor seizures mostly at night, good response without treatment in many cases, and a very good prognosis with remission by adolescence [1][4][5]. Juvenile Myoclonic Epilepsy, on the other hand, is a lifelong condition that requires ongoing management.
[1] Mayo Clinic. (2021). Rolandic Epilepsy. https://www.mayoclinic.org/diseases-conditions/rolandic-epilepsy/symptoms-causes/syc-20353200
[2] National Institute of Neurological Disorders and Stroke. (2021). Epilepsy. https://www.ninds.nih.gov/Disorders/All-Disorders/Epilepsy-Information-Page
[3] Epilepsy Foundation. (2021). Medications. https://www.epilepsy.com/learn/treating-seizures-and-epilepsy/medications
[4] Johns Hopkins Medicine. (2021). Rolandic Epilepsy. https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/epilepsy/conditions/rolandic-epilepsy.html
[5] American Academy of Neurology. (2021). Practice Guideline: Evaluation and Management of Childhood Absence Epilepsy. https://www.aan.com/guidelines/practice-parameter/evaluation-and-management-of-childhood-absence-epilepsy/
[6] Epilepsy Foundation. (2021). Juvenile Myoclonic Epilepsy. https://www.epilepsy.com/learn/types-of-seizures/generalized-tonic-clonic-seizures/juvenile-myoclonic-epilepsy
- Although BRE is considered 'benign' and typically resolves by adolescence, it can sometimes lead to learning difficulties and speech abnormalities in early onset cases.
- Pfizer's Neurontin (gabapentin) is a commonly used antiepileptic drug for the treatment of conditions such as BRE.
- Juvenile Myoclonic Epilepsy, unlike BRE, is a lifelong condition that requires ongoing management due to the occurrence of seizures within specific times of the day.
- The prognosis for a child with BRE is very favorable, with less than 2% of affected children developing generalized seizures in adulthood, but regular medical check-ups are essential for pediatric mental health and neurological disorders like this.
- Health and wellness for children with epilepsy, such as BRE, involves understanding science-backed treatment options, monitoring mental health, and regular neurological evaluation.
