What is a syndrome?
A syndrome is a group of signs and symptoms that, added together, suggest a particular medical condition. In epilepsy, examples of these signs and symptoms would be things like the age at which seizures begin, the type of seizures, whether the child is male or female and whether they have physical or learning disabilities, or both. The results of an electroencephalogram (EEG) are also used to help identify epilepsy syndromes.
If you would like to know more about an epilepsy syndrome, please speak to your doctor. If you would like to know more about epilepsy in general, please contact Epilepsy Action.
Other names for benign rolandic epilepsy
• benign rolandic epilepsy of childhood (BREC)
• benign epilepsy with centro-temporal spikes (BECTS)
Benign rolandic epilepsy
Benign rolandic epilepsy is called 'benign' because it has a good outcome. Nearly all children with it will outgrow it during puberty. It is called ‘rolandic' because the seizures begin in the part of the brain called the rolandic area. Mostly, the seizures are focal (partial), because only this part of the brain is involved.
Benign rolandic epilepsy is one of the most common types of epilepsy in children. It affects boys and girls equally, and almost one in five of all children who have epilepsy. It usually starts between the ages of three and 10 years, and often stops around puberty (aged 14-18 years). Children who have this type of epilepsy are usually well otherwise, and do not have learning difficulties. Some children, however, have specific difficulties with reading and language, or with drawing and visuo-spatial skills.
Seizures often start as the child is asleep or waking up in the morning. They have a feeling of tingling (like pins and needles) on one side of their mouth, involving the tongue, lips, gum and inner side of their cheek. The seizure may also involve the throat, which may cause the child’s speech to be unclear and therefore difficult to understand. The child may make strange throaty or gurgling noises, and it is often this which alerts parents that something may be wrong. The child often knows what they want to say but cannot speak properly.
The seizure may also cause twitching movements (called clonic movements) or a stiffness (called a tonic movement) of one side of the face. These movements may then spread to the arm and/or the leg, usually on the same side as the movements in the face. Occasionally, both sides of the body are affected. When this happens, the child loses consciousness, becomes stiff and has regular, jerking movements of their arms and legs. This is called a tonic-clonic seizure. A tonic-clonic seizure is a generalised seizure (affecting both sides of the brain). The child may also be incontinent. After this seizure, the child will be sleepy and some children may sleep for a few hours.
Diagnosis involves a full and accurate history of the seizure(s) and an EEG test. The EEG records the electrical activity in the brain. In benign rolandic epilepsy, the EEG will pick up epileptic activity in the rolandic – also called the centro-temporal – area of the brain. Sometimes the EEG may be normal. This doesn’t mean that the child doesn’t have this epilepsy syndrome. Occasionally a sleep-deprived EEG recording may help with the diagnosis.
Epilepsy Action has more information about diagnosing epilepsy.
Treatment with epilepsy medicines is not always considered necessary, since seizures tend to disappear when the child gets to puberty. Also, many children will only have one or two seizures and therefore will not need any treatment. However, many parents, and most doctors, feel reassured by treatment. The epilepsy medicines carbamazepine (Tegretol), lamotrigine (Lamictal) or sodium valproate (Epilim) are almost certain to be effective in controlling seizures.
There may be research studies open that are relevant to this epilepsy syndrome. Your child’s doctor will be able to discuss this with you.
Information about treatments for children can be found on the Medicines for Children website.
The fact that this type of epilepsy is called benign means that it has a very good outcome. Nearly all children with benign rolandic epilepsy will outgrow the tendency to have seizures when they reach puberty.
Children who have benign rolandic epilepsy do not usually have learning difficulties. Some may have some problems with reading and language, but most cope well with school work.
Epilepsy Action would like to thank
- Dr Richard Appleton, and Dr Rachel Kneen, consultant paediatric neurologists at Alder Hey Children’s Hospital, Liverpool, UK and
- Dr Stewart Macleod, consultant paediatric neurologist at Royal Hospital for Sick Children, Glasgow, UK.
They have kindly prepared the information on this page. It is based on their own research, experience and expertise.