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Benign rolandic epilepsy

Benign rolandic epilepsy is called 'benign' because it usually 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. The ‘rolandic’ is also the ‘centro-temporal’ part on the brain’s surface. 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 slightly more frequently than girls. Almost one in 5 of all children who have epilepsy will have benign rolandic epilepsy. It usually starts between the ages of 3 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 major learning difficulties. However, a significant minority (possibly 10-15%) of children will have difficulties with reading and language, or with drawing and visuo-spatial skills.

The cause for benign rolandic epilepsy is not known. It is probably caused by a genetic abnormality but none have been found as yet.

Other family members, such as a parent or grandparent may also have had this type of epilepsy when they were children. Occasionally, other family members may have a different type of epilepsy.

Other names for benign rolandic epilepsy

• benign rolandic epilepsy of childhood (BREC)
• benign epilepsy with centro-temporal spikes (BECTS)

Symptoms

Seizures often start as the child is asleep or just about to wake 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. Children sometimes describe their tongue or lips as being “fizzy” or “buzzing”. 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 mouth or 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

The diagnosis of this epilepsy involves a full and accurate history of the seizure(s) and an EEG (electroencephalogram) test. The EEG records the electrical activity in the brain. In benign rolandic epilepsy, the EEG will pick up epileptic activity in the rolandic – 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, if the first EEG is normal, the hospital doctor will arrange a sleep-deprived EEG recording. This is because abnormal brain activity on the EEG is more easily seen when someone is tired or falling asleep.

Brain scans, including magnetic resonance imaging (MRI) scans are usually normal. The majority of children with a very clear history and EEG of benign rolandic epilepsy do not need to have an MRI brain scan.

Treatment

Treatment with an epilepsy medicine is not always considered necessary, because seizures usually remit (‘go away’) when the child gets to puberty. Also, many children will only have one or 2 seizures in a year, and therefore will not need any treatment. However, many parents, and some doctors, feel reassured by giving the child treatment. This is particularly true if the seizures happen frequently, every month or so, or if the seizures are generalised tonic-clonic seizures. The epilepsy medicines, carbamazepine (Tegretol), lamotrigine (Lamictal), levetiracetam (Keppra) or sodium valproate (Epilim) are very effective in controlling seizures.

There may be research studies that your child could take part in if they have this epilepsy syndrome. Your child’s hospital doctor will be able to discuss this with you.

Information about treatments for children can be found on the Medicines for Children website.

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, and nearly always before their 16th birthday.

Children who have benign rolandic epilepsy do not usually have learning difficulties. However, some children will have difficulties with reading and language, and might need some support. Most children 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

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.

Code: 
S003.03

Epilepsy Action would like to thank Dr Richard Appleton, consultant paediatric neurologist at Alder Hey Children’s Hospital, Liverpool, UK for preparing this information.

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

  • Updated November 2016
    To be reviewed November 2019

Comments: read the 17 comments or add yours

Comments

A bit like Jeanette, my daughter had her first seizure that I had witnessed in the car about a year ago. She has had a bike accident a few days previous and badly gashed her finger so had been for follow up. She dozed off to sleep then made a noise and was drooling excessively and couldn't speak properly when she came out of it. Was so scared. Went to doctor about it and they said to observe it. Saw it happen a further two times at periods of extreme tiredness. She was referred to a paediatrician who put it down to parasomnia with some complex episodes. Then in June she had a one at the dinner table, then alarms bells started ringing. Got an emergency appt with her paediatrician and they organised an eeg. She now has one nearly every night as she goes to sleep but she is totally aware of what is happening. She has the classical symptoms on BRE but her eeg is normal and is now awaiting a sleep deprived eeg to see what that picks up. She is now 9 and is otherwise totally well. So scary when I witness it and she is so embarrassed by it that she won't let me video it for her consultant and turns her head away every time I try. Have asked about medication but her consultant isn't happy to medicate her yet. We go in holiday in a few weeks and the flight it scaring me incase something goes wrong.

Submitted by Judith Middleton on

Hi Judith
Waiting for a diagnosis can be a stressful and anxious time. It doesn’t help that there isn’t any one test that can say if a person has epilepsy or not.

https://www.epilepsy.org.uk/info/diagnosis/diagnosing-epilepsy

It must feel strange for your daughter having her episode filmed, but try explain how important it can be for her doctor. No one but the doctor will see it, and it might speed up her diagnosis.

To try help you feel more relaxed about your family holiday, you may wish to look at our  traveling for people with epilepsy webpage:

https://www.epilepsy.org.uk/info/travelling-abroad.

I hope the doctors are able to diagnosis what is happening to your daughter soon so she can start the relevant treatment to stop them.

If we can be of any more help, please feel free to contact us again, either by email helpline@epilepsy.org.uk or phone the Epilepsy Action Helpline freephone 0808 800 5050. Our helpline is open Monday to Friday, 8.30am until 5.30pm.

Regards
Diane Wallace
Epilepsy Action Advice and Information Team

Submitted by Diane, Epilepsy... on

Hi
My daughter is nine years old she was diagnosed with rolandic epilepsy last November when she suffered seizures since then she has had a couple of epileptic fits in March and August this year. All the fits have to me been quite violent ones.

What worries me the most is that she stops breathing goes purple in the face. She is on no medication and her fits have not only taken place at night but during the day.

I just want some reassurance that her breathing will not stop that's scares me the most.

Submitted by Shaziah on

Hi Shaziah
From your description I think you are referring to a tonic-clonic seizure. If I’m right, seeing your daughter experience this type of seizure will be distressing.

During a tonic-clonic seizure it's not uncommon for a person to go blue. It's known as cyanosis and often affects the area around the mouth and, we understand, the nails. It happens when the oxygen is taken up by the vital organs, such as the brain and heart, rather than the less important ones, such as the lips and nails. To help aid your daughters breathing return to normal, when her seizure is over (stopped convulsing) put her into the recover position. We explain and show how to do this on our first aid webpage.

epilepsy.org.uk/info/firstaid

If any of the following happened, you would call for an ambulance:

• The seizure continues for more than five minutes, or

• One tonic-clonic seizure follows another without your daughter regaining consciousness between seizures, or

• She is injured during the seizure, or

• You believe that she needs urgent medical attention

If your daughter seizures are becoming more frequent or severe maybe talk to her epilepsy doctor about treatment options.

I hope this information reassures you. If you would like to discuss this or any other issue regarding your daughters epilepsy, please feel free to contact us again, either by email helpline@epilepsy.org.uk or the Epilepsy Action Helpline freephone 0808 800 5050. Our helpline is open Monday to Friday, 8.30am until 5.30pm.

Regards
Diane Wallace
Epilepsy Action Advice and Information Team

Submitted by Diane, Epilepsy... on

Our 8 year old chyanne has (Benign rolandic seizures) she was born with cp and it has taken till now to get this far ahe on something to help but she has a lot going on with her apart from her cp

Submitted by sheena on

Hello Sheena
Seeing someone you love having seizures can be difficult. It is good that you have found something to help Chyanne.

Some people tell us that connecting with other people who understand epilepsy makes a difference to them. Our online community forum4e, or one of our coffee and chat groups are a great way to do this.

You may also find it helpful to get in touch with Contact a Family, who offer support to families with disabled children. They have a lot of useful information on their website, and may be able to connect you to other families in a similar situation near you.

If you would like to talk about any of this, or if we can be of any more help, please feel free to contact us again, either by email or the Epilepsy Action Helpline freephone 0808 800 5050.

Karen
Epilepsy Action Advice & Information Team

Submitted by Karen, Epilepsy... on

What is the average frequency of benign rolandic seizure? My 9-yo daughter had been diagnosed with rolandic seizure about a year ago. We refused to take medication since the episodes are within control so far. Her episodes lapse the shortest in 1 week, and the longest in 6 months. In a year, we have experienced total of 10 episodes.

Submitted by RIna on

Hi Rina
The frequency of benign rolandic seizures does vary from child to child. I don’t have an average figure. But quite often a child may only have a relatively small number of seizures before the syndrome disappears. That’s why, as with your daughter, a number of parents will take the decision for their child not to take epilepsy medicines.

Best wishes.

Shelley
Epilepsy Action Advice and Information Team

Submitted by Shelley, Epilep... on

Hi , my Daughter has 7 years old , one day after her birthday she was in her friend house (sleepover) she had a seizure , she said she feels a stomach discomfort, them her mouth started open and close ,she eent to the bathroom to look on the mirror and start drooling , whem her friend araived to the bathroom, she was shaking one arm and one leg , they called 911. And ambulance took her to the hospital , she was not recognized me for about 20 min. Was terrible , ....she always had a really bad sleep ,sice she born , ...she moves a lot , rigind teeth and make a noise like she swalling something , ..she cries and seat on bed , ...I don't know what happens to her ee waiting for eeg results , ...whem I was 6 months old I had 4 in one day , nobody knows what caused, I took medice for one year and nobody found what happened to me ....and I never had another one ....please help me ....Thank you. Im so afraid the she dies

Submitted by ana oliveira on

Hi Ana
It is a very worrying and scary time when your child has suspected seizures. It’s good the doctors are now doing tests. If you don’t already, it could help the doctors is you start to keep a diary of her suspected seizures. It can also help the doctor if you video her when you think she is having a seizure. 

If it is epilepsy, they may suggest she starts on epilepsy medicine.

To help with your fears you may wish to view our information on safety and first aid. In most case, we find parents can find it helpful to talk to or contact people who understand what they are experiencing. If you think this could help you, you may find some of our services helpful. Such as our forum4e online community, facebook and twitter.

If you are in America (I believe 911 is the emergency service for America) you may also find it helpful to contact the Epilepsy Foundation of America for local support.

Regards
Diane
Epilepsy Action Advice and Information Team

Submitted by Sacha on

Hi thank you for support we got the results and it's showing benign rolandic epilepsy , she so has has only one seizure ,thanks God , dr said it's better wait for medicine , he said it may happens just pne more time ,....is it that true? What is the percentage of kids who had only one is two? Thank you for your attention where I leave has just pne pediatric neurologist and our appointment its with one month and I need to.ask this ....Thank you

Submitted by ana oliveira on

Mh daughter was diagnosed yesterday with benign rolandic epilepsy , is it true that some kids has just one or two seizure on the lifes ? Without medication ? ....her seizure start in the morning with her mouth open.and.closed then she drooled and passed to arns hands and leg ....lasted 6 min.

Submitted by ana oliveira on

Hi Ana

It’s good to hear you have a definite diagnosis for your daughter.

Benign rolandic epilepsy  is called 'benign' because it has a good outcome. Nearly all children with it will outgrow it during puberty.

We don’t have figures but many children with benign rolandic epilepsy will only have one or two seizures and therefore will not need any treatment.  But in the UK, many parents, and most doctors, feel reassured by treatment.

Regards

Diane
Epilepsy Action Advice and Information Team

Submitted by Diane@Epilepsy ... on

Hey, I'm a 16 year old girl and i got diagnosed with benign rolandic seizures when i was 15. Ever since i got diagnosed the doctors prescribed me with Levetiracetam 500mg twice a day and since then ive not had any seizures but yesterday at school in my art lesson i had an aura it came on for no reason well i didnt have any tablets to take the night before and that morning so was it due to not having any tablets to take? And i also had 3 auras earlier they only lasted a few seconds i jsut want to know what is bringing on my auras and will i ever grow out of my epilepsy at 16? I dont know if its my exams thats causing me to stress and then have an aura as a result maybe? Help me please

Submitted by Daisy on

Hi Daisy
Yes it’s really likely that your auras happened because you missed your tablets. Just missing one dose can make it more likely you’ll have a seizure. So it’s a really good idea to try never to run out of your tablets.

Stress and lack of sleep can be seizure triggers for some people too.

You might want a look at our information on stress and on wellbeing. They both have information to help you manage your stress levels a bit.

To our understanding many people who are diagnosed with benign rolandic epilepsy grow out of it once they are though puberty.

I hope this helps a bit. And that your exams go well.

Cherry
Epilepsy Action Advice and Information team

Submitted by Cherry, Epileps... on

My 8 yr old son has just been diagnosed with benign rolandic epilepsy. He's had about 4/5 episodes. We are unsure whether or not to go down the treatment route or leave him unmedicated as we don't know the side effects of the drugs used to treat the condition. Has anyone god any good advice or knowledge they can share please?

Submitted by Trisha Johns on

Hi Trisha

This is a difficult decision that many parents struggle with. As well as the benign rolandic epilepsy (BRE) information you might want to look at our information on starting medicine, in our children’s section. As you will have seen doctors are often happy for children with BRE not to have epilepsy medicine. But it may offer you some level of reassurance.

You might also want to go to our online community forum4e and look at posts or ask other parents about how they have made their decision. The community is for people with epilepsy and carers of people with epilepsy.

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.

Regards

Cherry  

Epilepsy Action Helpline Team

Submitted by Cherry-Epilepsy... on