[Broad clinical and prognostic spectrum of the Rolandic epilepsies. Typical forms]

We reviewed studies on Rolandic epilepsies (ER) and analyzed them according to definite criteria to establish the typical clinical and electroencephalographic phenotypes and therapeutic strategy to be used.

The criteria for definition leave gaps which permit inclusion, as typical forms of ER, variant forms or syndromes related to ER. Clinical phenotypes: 1) Classical phenotypes with senso motor, phonatory or autonomic seizures; 2) Benign partial state which is rarely seen; 3) ER with cognitive involvement usually of attention, reading, auditory verbal learning, semantic fluency and visuomotor coordination; 4) Idiopathic ER with interictal facial myoclonus; and 5) Other phenotypes include ER coinciding with a pre existing cerebral disorder and transient EPOCS of iatrogenic origin. EEG phenotypes: 1) Classical EEG with unilateral or bilateral, synchronous or asynchronous Rolandic paroxysms; 2) Phenotypes with generalized PO; 3) Phenotype with centroparietal slow waves, rare and usually transient. The various authors do not agree as to whether treatment should be recommended although in the studies we consulted there was a high proportion of ER and it was recognized that the risk of inducing EPOCS on treatment was low.

Analysis of the literature of typical forms of ER shows that apart from the classical form there is a continuous range of epileptic dysfunction, both clinical and of EEG, which includes the related variant forms and syndromes, although the long term prognosis of all is good, some with and some without treatment