[Polymorphism of electroencephalographic pattern in benign epileptiform discharges in childhood]
Insights
Benign epileptiform discharges of childhood (BECD) are not exclusive to epilepsy and appear in various neurodevelopmental disorders. These rolandic spikes can indicate broader "hereditary impairment of brain maturation" in children.
Area of Science:
- Pediatric Neurology
- Neurophysiology
- Epileptology
Context:
- Benign epileptiform discharges of childhood (BECD), also known as rolandic spikes, are a common EEG finding in children.
- Their significance in children with and without epilepsy requires further elucidation.
- This study investigates the incidence and clinical correlates of BECD in a large pediatric cohort.
Purpose:
- To determine the incidence and significance of BECD in children aged 2-15 years.
- To compare BECD characteristics in children with and without epilepsy.
- To explore the association of BECD with neurological and neurocognitive abnormalities.
Summary:
- A study of 2723 children (841 with epilepsy, 1882 without) found BECD in 1.33% of the non-epileptic group.
- BECD expression peaked at different ages depending on epilepsy status.
- Non-epileptic children with BECD often had neurological issues like ADHD and speech delay; hemispheric laterality differed between groups.
- Morphological similarities were noted across various epilepsy syndromes and BECD patterns.
- BECD are considered nonspecific and may reflect broader hereditary brain maturation impairments.
Impact:
- Highlights BECD as a potentially nonspecific finding, broadening its diagnostic implications beyond epilepsy.
- Suggests a potential link between BECD and a spectrum of hereditary neurodevelopmental disorders.
- Provides insights into the age-related expression and hemispheric lateralization of BECD in pediatric populations.
- Contributes to understanding the electroclinical features of focal brain dysfunction and hereditary mechanisms.
Abstract:
Incidence and significance of benign epileptiform discharges of childhood (BECD), or rolandic spikes, have been studied in 2723 children, aged 2-15 years, with (841 patients) and without (1882) epilepsy. All the patients underwent standard electroencephalographic (EEG) study with video-EEG monitoring made in cases of epileptiform abnormalities. In the non-epileptic group, BECD frequency was 1.33%. There was a significant predominance of boys in both groups. The age of maximal BECD expression was 4-5 years in the non-epileptic group and 9-10 years--in children with epilepsy. The majority of children without seizures demonstrated different neurological and neurocognitive abnormalities, such as chronic headaches (25%), attention deficit hyperactivity disorder (25%) and speech delay (21%). Epileptiform abnormalities were observed mostly in the right hemisphere in children with epilepsy and in the left hemisphere in non-epileptic patients. There was a morphological similarity of electroencephalographic patterns in patients with rolandic epilepsy, benign occipital epilepsy, pseudolennox syndrome, Landau-Kleffner syndrome and electrical status epilepticus during slow sleep. The authors conclude that BECD are nonspecific feature of rolandic epilepsy and can occur in the broad spectrum of disturbances forming "hereditary impairment of brain maturation" group. Hereditary mechanisms involved in realization of various electroclinical features of focal brain dysfunction are suggested.
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