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Prolonged intermittent drooling and oromotor dyspraxia in benign childhood epilepsy with centrotemporal spikes
E Roulet1, T Deonna, P A Despland
1Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Insights
This study describes a child experiencing prolonged drooling due to benign childhood epilepsy with centrotemporal spikes (BCECS). Symptoms correlated with EEG findings, suggesting an epileptic focus in the lower rolandic fissure.
Area of Science:
- Neurology
- Pediatric Neurology
- Epileptology
Background:
- Prolonged isolated sialorrhea (excessive drooling) of epileptic origin was previously documented by Penfield and Jasper in 1954.
- Benign childhood epilepsy with centrotemporal spikes (BCECS) is a common epilepsy syndrome in children.
Observation:
- A case of prolonged, intermittent drooling, lingual dyspraxia, and other symptoms consistent with BCECS is presented.
- The patient's symptoms fluctuated in correlation with electroencephalographic (EEG) paroxysmal discharges.
- Magnetic resonance imaging (MRI) did not reveal any structural lesion.
Findings:
- The clinical presentation and EEG findings suggest an epileptic dysfunction in the lower rolandic fissure as the cause of sialorrhea.
- The intermittent nature of symptoms aligns with the fluctuating seizure activity characteristic of BCECS.
Implications:
- This case expands the understanding of potential clinical manifestations of BCECS beyond typical seizures.
- It highlights the importance of considering epileptic dysfunction in the differential diagnosis of prolonged sialorrhea in children.
- The findings may contribute to recognizing parallels with conditions like status epilepticus in BCECS and acquired aphasia-epilepsy syndrome.
Abstract:
Prolonged isolated sialorrhea of epileptic origin was described by Penfield and Jasper (1954) in a patient with a lesional epilepsy. A child with prolonged but intermittent drooling, lingual dyspraxia, and other clinical and electroencephalographic (EEG) features compatible with benign childhood epilepsy with centrotemporal spikes (BCECS) is described. The fluctuant course of the symptomatology and correlation with the intensity of the paroxysmal discharges on EEG are consistent with an epileptic dysfunction located in the lower rolandic fissure. No lesion was demonstrated by magnetic resonance imaging (MRI). Our case bears analogies with the recently reported status epilepticus of BCECS and the "acquired aphasia-epilepsy syndrome."