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Atypical rolandic epilepsy

Natalio Fejerman1

  • 1Department of Neurology, Hospital de Pediatria JP Garrahan, Buenos Aires, Argentina. natalio@fejerman.com

Epilepsia
|August 18, 2009
PubMed

Insights

Benign rolandic epilepsy (BRE) in children can involve cognitive and behavioral issues, not always indicating atypical development. Early onset and frequent spikes may predict neuropsychological deficits and atypical BRE evolution.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Neurodevelopmental Disorders

Background:

  • Typical benign rolandic epilepsy (BRE) is a common childhood epileptic syndrome.
  • Mild cognitive and behavioral difficulties are increasingly observed in BRE and are not necessarily atypical.
  • Atypical features require electroclinical confirmation.

Purpose of the Study:

  • To clarify the distinction between typical and atypical features in benign rolandic epilepsy.
  • To identify risk factors for neuropsychological deficits and atypical evolution in BRE.
  • To understand the spectrum of atypical BRE manifestations.

Main Methods:

  • Review of electroclinical features in childhood epilepsy.
  • Analysis of age at onset and spike-wave discharge frequency.
  • Correlation of clinical presentation with neuropsychological outcomes.

Main Results:

  • Early onset and frequent spikes in BRE are associated with neuropsychological deficits.
  • Atypical BRE evolution is characterized by severe impairments and continuous spike-and-waves during slow sleep (CSWSS).
  • Syndromes like atypical benign focal epilepsy of childhood (ABFEC), BRE status, Landau-Kleffner syndrome (LKS), and CSWSS may represent a continuum.

Conclusions:

  • Mild cognitive/behavioral issues in BRE are common and not always atypical.
  • Specific electroclinical features predict a risk for atypical BRE evolution and neuropsychological deficits.
  • Atypical BRE presentations may exist on a spectrum, including ABFEC, LKS, and CSWSS.

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