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Benign rolandic epilepsy

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.

Epilepsy Action has more information about seizure types, learning disabilities, and the EEG.

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.

Symptoms

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

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

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.

Epilepsy Action has more information about epilepsy medicines.

Outlook

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.

Support 

Contact a Family
Freephone helpline (UK only): 0808 808 3555
Website: cafamily.org.uk
Email: info@cafamily.org.uk

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Code: 
S003.02

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.

This information is exempt under the terms of The Information Standard.

  • Updated August 2013
    To be reviewed August 2016

Comments: read the 13 comments or add yours

Comments

My grandaughter who is 7 yrs old had on fit about three years ago and after necessary tests and evaluation including an eeg she was put on targetrol and she has been on this ever since. She has been having trouble concentrating in school and doing written work.Last week the targetrol was reduced by 50mg per day on medical advice and there seems to be an immediate improvement in her learning abilities. Is this a likely result of the reduction in dosage- please let me know - Thanks

Submitted by K Gururaj on

Different people respond differently to epilepsy medicines. But lack of concentration is one of the more common side-effects of Tegretol. So it is highly like the dose reduction will have helped your granddaughter feel more awake and able to concentrate on her studies. I do hope this continues for her.

Cherry

Advice and Information Team

Submitted by Cherry on

Thank you for your prompt reply reg my grand daughter who is 7 yrs old and has been on tergetrol 400 mg for the last three years after one episode about 3 years ago. She has had trouble concentrating and writing at school and a week ago the med was reduced by 50 mg with a plan to reduce by 50mg every 4 weeks and eliminate it. Even after the first reduction there has been a marked improvement in her concentration and behaviour and the parents will continue the reduction of med for the next three months. The neurologist is suggesting as an option an eeg before finally going off the med tegretol but the parents dont like this since she has to be sedated for this . Is it ok not to go in for eeg??? What precautions or preparations should the parents take in case there is an unexpected attack after the meds are cut off Thanks K Gururaj a concerned grand father

Submitted by K Gururaj on

Hi. I’m glad you found the reply useful.

Your granddaughter’s parents do have the right to say they don’t want her to have an EEG. But it could show if your granddaughter is still having any epileptic activity. If she is, coming off the Tegretol could mean she had more seizures. It’s interesting that your granddaughter would have to be sedated for the EEG. This is not the usual practice in the UK. Maybe they could discuss this further with her epilepsy specialist.

As there would be a slightly higher risk of her having a seizure while she comes off the Tegretol, it would be good for her parents to be a little more careful with her. The main thing would be for her to be careful around water, for example not having a bath or going swimming without someone nearby.

I do hope all goes well for her.

Cherry

Advice and Information Team

Submitted by Cherry on

I was driving my car, going to the grocery store my daughter was in the back seat of the car. I heard snorting, and i called out her name she didn't respond so when i looked back she was drooling excessive and pointing to her mouth she couldn't speak to me or make out clear words. This was the first time. I was frantic she said she was thirsty she came out of it quick. I gave her water. I took her home my husband and I decided if it happened again we were going to the hospital. That evening i went to pick my oldest daughter at the mall and I put my 8 year old in the car with me, all was well almost home i pulled over to the side when i saw her do the same thing, drooling and gurgling like sounds snorting, i panicked again she was trying to speak to me but couldn't. went to the hospital they did blood work and CT scan all was normal i was sent home, they told me follow up with dr and see a pediatric neuro specialist. The next day going to church it happened again in the car this time facial movement gurggling drooling she couldn't speak i cried all the way to the hospital took her to a different one, they did nothing said it sounds like a seizure. they said follow up with a neuro. why is this only happening in the car? why does she sound like she is choking. I feel so afraid at this point she sleeps with me, I'm even afraid to get in a car. Yesterday i took her to her pediatrician and i laid her down and away from looking at the road and she did well no seizure at all, I'm afraid to sit her up in the car. I told the dr he said it could just be a coincidence. Can this intact be a seizure?

Submitted by Jeanette Rivera on

Hi Jeanette

Thank you for your questions.

It must be difficult and frustrating waiting to see the paediatric neurologist. As trained epilepsy advisers, we can give you general information on epilepsy but we are unable to diagnose your daughter’s symptoms. As there are a number of medical conditions that can cause symptoms similar to epilepsy, the doctor will need a history of your daughter’s symptoms to help with their decision. You may wish to keep a diary  to help the doctor. It can also be helpful to ask others such as school to note anything they witness.

Some things make seizures more likely for some people with epilepsy. These are often called ‘triggers’. Triggers do not cause epilepsy itself, but they are things that make it more likely that a person with epilepsy will have a seizure. There are two triggers that could be relevant to a car journey. These are tiredness and flashing or flickering lights.

Some child fall a sleep during a car journey, for some people with epilepsy, their seizures are related to their sleep pattern.

Or as the doctor suggested, it may just be a coincidence.

I hope this is of help.

Regards

Diane Wallace

Advice and Information Team

Submitted by Diane on

My son is12,and has BRE. It started last yr and had no seizure since July 2013. Then BANG 2 in the space of 4 days. I'm terrified. I no that this is one of the best epilepsy that I could ask for, but it's still scary. Is there anything that I could b doing at night to help prevent the seizures when he wakes up?

Angela

Submitted by Angela moore on

Hi Angela

Thanks for your question. What you are feeling is quite natural, we know how frightening it can be when your child has seizures.

The best thing to do would be to consult with your son’s epilepsy specialist. If your son is taking epilepsy medicines, then they might need adjusting. If he isn’t taking medicine then this could be something to discuss with the epilepsy specialist. Also, you could have a look at our common seizure triggers page to see if you find it relevant to your son.

You might find it helpful to speak to other parents of children with epilepsy through our online community forum4e. Chances are you will find parents of other children in similar situations who can share their experiences and support.

I hope things get better soon.

Sacha

Advice & Information Team

Submitted by Sacha-Epilepsy ... on

We have been given a diagnosis of benign Rolandic epilepsy for our son although I am concerned as our son does have learning difficulties and even attends a special ed school.... could we have a misdiagnosis...

Submitted by laura on

Hi Laura

The diagnosis of benign rolandic epilepsy may be completely unrelated to your son’s learning difficulties. There is  research to suggest that benign rolandic epilepsy has a genetic element to it.

Benign rolandic epilepsy is often diagnosed fairly clearly by seeing a particular pattern on the EEG.

Sometimes a doctor will not think it is necessary for a child with benign rolandic epilepsy to be put on epilepsy medicine. So if some of your concern is around not wanting your son to be put on medicine, it may be possible to discuss this with the doctor.

If you don’t feel the doctor is qualified to make this diagnosis then you could consider getting a second opinion. Here is our information on what to do if you are unhappy with your treatment.

I hope this is useful. But If we can be of any more help, please feel free to contact us again, either by email or the Epilepsy Helpline freephone 0808 800 5050.

Yours sincerely

Cherry

Advice and Information Team

Submitted by Cherry-Epilepsy... on

Hi my 6yr old daughter has had rolandic epilepsy for about 2 and a half years and has been on carbamazepine for about 22 months
she was due to be weened off the medicine in janurary as she hadnt had a seizure since taking it but has had a minor one and an extreme one in the space of 4 days
we have an appointment later this week with the specialist but would like to know your views on this as I find it worrying

Submitted by sean on

Hi Sean

Thank you for your post. Your concern is understandable, and it’s good you’re due to see her specialist. Some children don’t grow out of benign rolandic epilepsy until around puberty. It could be that she is still a bit too young to consider reducing her epilepsy medicine, and that her dose of carbamazepine might need adjusting as she has grown. This is quite usual for children.

Sacha

Advice & Information Team

Submitted by Sacha-Epilepsy ... on

Hi, I've had and grow out of benign rolandic epilepsy which took apromiately six years between the ages of nine and 15. Over those six years I have had good seizures and bad seizures. I feel that it is all to do with how tired and stressed the body is before you fall asleep as my worst ones were usually during school holidays and on occasion around exams time. Hope this helps

Submitted by Rebecca on

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