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Benign rolandic epilepsy

Benign rolandic epilepsy of childhood (BREC), Benign epilepsy with centro-temporal spikes (BECTS), Benign epilepsy of childhood with centrotemporal spikes (BECCT)

Overview

Benign rolandic epilepsy (BRE) is the most common form of childhood epilepsy. It is referred to as "benign" because most children outgrow the condition by puberty. This form of epilepsy is characterized by seizures involving a part of the brain called the rolandic area. These seizures typically begin between the ages of 3 and 12 years and occur during the nighttime. Other features of BRE include headaches or migraines and behavioral and/or learning differences. BRE is thought to be a genetic disorder because most affected individuals have a family history of epilepsy. Treatment is usually not indicated; however for individuals that have seizures in the daytime, common seizure medications such as Trileptal, Tegretol, and Keppra might be prescribed.

Symptoms - Benign rolandic epilepsy

BRE typically begins between the ages of 3 and 13 years with nighttime seizures. The episodes usually begin with twitching and stiffness in the face, that often wakes up the individual. There may be a tingling feeling on one side of the mouth that involves the tongue, lips, gums and inside of the cheek. The seizure can also involve the throat, which may make speech unclear and difficult to understand. Occasionally, both sides of the body may be affected, which can lead to stiffness and jerking movements of the arms and legs, and loss of consciousness. Loss of bladder control (incontinence) may also occur.

Some individuals with BRE experience headaches or migraines, learning difficulties, and behavioral problems during the period of time that they have seizures. Once seizures stop and brain activity returns to normal, these issues usually resolve.

Causes - Benign rolandic epilepsy

BRE is thought to be a genetic disorder. Studies suggest that certain regions on chromosome 11 (11p13) and chromosome 15 (15q14) may be involved in BRE, but a specific gene has not been identified.

Prevention - Benign rolandic epilepsy

Not supplied.

Diagnosis - Benign rolandic epilepsy

A normal child having such seizures is given an EEG test to confirm the diagnosis, a test that graphs the pattern of electrical activity in the brain. BRE has a typical EEG spike pattern - repetitive spike activity firing predominantly from the mid - temporal or parietal areas of the brain near the rolandic (motor) strip.

Prognosis - Benign rolandic epilepsy

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.

Treatment - Benign rolandic epilepsy

Usually treatment is not necessary because the seizure episodes are infrequent and typically end by puberty. When episodes are more frequent or occur in the daytime, antiseizure medications, such as carbamazepine, phenobarbital, phenytoin, valproic acid, clonazepam, clobazam, gabapentin, and levetiracetam may be utilized. Most individuals respond to a low dose of a single drug; however rarely, a combination of different medications is needed.

Resources - Benign rolandic epilepsy

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