[Rolandic spikes as an electroencephalography manifestation of oligodendroglioma]

A 10 5/12 year old boy was presented with seizures of uncertain origin on to the psychosomatic ward of our University Children's Hospital. The question and problem was the distinction of psychogenic versus epileptogenic origin (repeatedly performed EEG's had shown normal findings, the seizures did not response to anticonvulsive therapy). The exploration of a psychodynamic causes of the presenting problem was excluded by family therapeutic and psychoanalytical case history and psychodynamic interview. The first pathological finding was seen with registration of a long term EEG with typical findings of temporal central spikes and waves as seen in the benign rolandic-epilepsia. The following diagnostic considerations were discussed and differentiated. a) benign rolandi epilepsia b) malign rolandi epilepsia c) psychomotoric seizures d) rolandic spikes as symptomatic finding of a brain tumor. The definite diagnosis was finally confirmed by a cerebral computer-tomography which showed a large expensive process in the interferior right regio temporalis, which was identified histologically after operation as a oligodendrogliom grad-I. The tumor was removed successfully as a whole without any neurological defects.