Benign Rolandic Epilepsy Flashcards
Semiology of a benign rolandic epilepsy seizure
- Onset:
- Classically occurs when falling asleep or awakening from sleep
- Features:
- Clonic or tonic activity of one side of the lower face
- Paresthesia of the tongue, lips, gum, and cheek
- Drooling and arrest of speech or dysarthria
- May or may not subsequently generalize
Epidemiology of onset for benign rolandic epilepsy/benign epilepsy with centrotemporal spikes
- Most common focal epilepsy of childhood
- Age of onset between 3-10 years
- Resolves spontaneously by age 18
- Family history is often present
Peri-rolandic region of the brain
- The Rolandic fissure is another name for the central sulcus
- Rolandic epilepsy gets its name because of its focal involvement of the motor and sensory strip
EEG in rolandic epilepsy/BECTS
Inter-ictally, it is characterized by the presence of “centrotemporal” or “perirolandic” spikes
These may be unilateral or bilateral
They become more prominent during sleep.
Treatment of benign rolandic epilepsy
- Most patients experience only one or less than a handful of seizures, and will grow out of the disease by age 18
- Studies recommend withholding treatment (watchful waiting) unless there were multiple seizures, cognitive changes, quality-of-life changes, and generalized tonic-clonic seizures
- Treatment is with levetiracetam, carbamazepine, or phenytoin
The most common focal epilepsy in children is ___.
The most common focal epilepsy in adults is ___.
The most common focal epilepsy in children is benign rolandic epilepsy.
The most common focal epilepsy in adults is temporal lobe epilepsy.
“Malignant rolandic epilepsy”
Seizures look similar to typical BECTS, but are frequent, difficult to treat, and do not spontaneously remit by 16 years of age.
It is likely that these patients have a different syndrome rather than a severe form of BECTS.
