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What is Benign Rolandic Epilepsy (BRE)? | Epilepsy
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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.

 

Speaker 1: Benign Rolandic is an epilepsy that starts in childhood.

The child often presents for the first time having had a seizure in the middle of the night which is really scary for parents. The child will wake out of sleep, often soon after going to sleep or soon before it's time to get up, with this horrible gurgling, guttural noise, drooling, being disoriented.

Speaker 2: So benign rolandic epilepsy is a syndrome. It's how it presents clinically and what the EEG looks like. The seizure starts in one area of the brain and spreads so when I look at the EEG I can see it. It has a special, funny look on the EEG that tells me it's benign rolandic. But, as you mentioned, these typically happen out of sleep, early in the morning, scare the daylights out of the parents with that gurgling sound.

Speaker 1: Right. We call that the semiology of the seizure. They very commonly present in the same way. They can be treated very easily. We decide about whether or not to treat them with medication based on what the EEG findings are. How often there's abnormalities on the EEG, whether the child is doing poorly in school, and, of course, how many seizures they have as well as how old the child is.

Speaker 2: What's so interesting is that a lot of these kids are triggered by sleep deprivation. The parents don't get them to bed early, they're up really late, they are overtired, and that's when the seizures come out. Many of these kids we don't have to treat with medication because if they get sleep, they're perfectly fine.

Speaker 1: We just make sure they get enough sleep. The problem with that is a lot of these kids end up being restricted from sleepovers where they're staying up until 2:00 in the morning. Parents who have weddings and the kids are up late, they feel like they can't take their children to the wedding. So they miss out on some social opportunities.

There is also an incidence, bigger than what we thought, we describe it as benign rolandic epilepsy, but actually the latest literature and the latest research shows that it may not be so benign. These children having a lot of abnormalities in their brains in sleep may be having more school and academic problems than we initially thought.

Speaker 2: It's very important to speak to your neurologist about not only the seizures, but how they're doing in school, what the learning is like, and what the attention is like. Even though they may not be clinically having seizures and are on no medication, it may be effecting their learning.

Speaker 1: Their school, the acquisition of knowledge, the memory that takes place during sleep at night.

Speaker 2: So benign rolandic epilepsy may not be that benign. It's a seizure that usually happens late at night caused by sleep deprivation. You may or may not need medication. You can discuss that with your neurologist. But check out what's going on in school because that's an important part of the whole picture.

Speaker 1: These kids are prime candidates for having a real neuropsychological evaluation which tests for learning disabilities, attention issues, and memory, to really keep on top of it and make sure nothing is happening that we can't prevent with medication.


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