Childhood epilepsy alongside centro-temporal spikes, previously known as benign rolandic epilepsy, is a type of epilepsy that occurs in children. The seizures in this kind of epilepsy are usually short and don’t persist into adulthood. They also don’t affect a child’s learning or intelligence.
Benign rolandic epilepsy leads to focal seizures that often involve one side of the body, typically the face. This kind of epilepsy generally doesn’t lead to long-term health issues or affect a child’s growth and development.
Healthcare providers can manage BRE with medications. In several cases, seizures stop on their own by the time the child reaches 16 years old.
What is it?
Benign rolandic epilepsy, now called childhood epilepsy alongside centrotemporal spikes, is a common type of epilepsy in children, making up about 15% of cases.
The condition leads to seizures, which are sudden ruptures of electrical activity in the brain that can cause symptoms like numbness or twitching. In Benign rolandic epilepsy, most seizures—more than 90%—happen at night while the child is sleeping, though they can occur during the day too.
Healthcare providers use the term “benign” since children typically outgrow BRE before reaching adulthood. It doesn’t affect their growth or development, and it usually doesn’t lead to long-term health problems. This means the chances of serious health issues are low.
Who it affects
Benign rolandic epilepsy usually affects children between 1 to 14 years old, with the highest number of cases occurring in those aged 7 to 10 years. It’s more frequent in boys, who are 1.5 times more likely to develop the condition compared to girls.
Children who have family members with seizure disorders are more likely to develop BRE. About 25 percent of children with BRE have the genetics of febrile seizures, which are fits triggered by epilepsy or fever.
Symptoms
During a benign rolandic epilepsy seizure, which usually lasts 2 to 3 minutes, the child is fully aware and awake. These seizures typically affect one half of the body and can manifest as facial jerking, arm and leg jerking, facial stiffness, tingling or numbness of the throat and face, trouble speaking, and sometimes drooling.
In some cases, a seizure may spread to two sides of the body, leading to additional signs such as stiffening, shaking, bladder or bowel incontinence, loss of consciousness, and a postictal state— a period of changed awareness after a seizure.
Apart from seizures, individuals with BRE might experience migraines, headaches, and learning or behavioral difficulties. Fortunately, these symptoms typically disappear once the seizures cease.
Treatment
Treatment for benign rolandic epilepsy varies based on the frequency and severity of seizures. Many children with BRE experience infrequent or mild seizures, so healthcare providers often do not recommend immediate treatment.
However, if a child has seizures that occur during the day, healthcare providers may suggest starting medication. This is especially true for children with cognitive or learning difficulties associated with their epilepsy.
Antiseizure medications are commonly used to manage BRE, and most children respond well to them. Options include drugs like Keppra, Neurontin, Tegretol, Lamictal (lamotrigine), Trileptal, Vimpat, and Zonegran. Healthcare providers typically begin treatment with a single medication instead of a combination of drugs.
If a child remains seizure-free for 1 to 2 years, healthcare providers may consider gradually reducing or stopping the medication. EEG tests can help healthcare providers determine the appropriate timing for this decision, ensuring the child’s safety and well-being.
Other types
Benign rolandic epilepsy (BRE) is the most frequent type of epilepsy in children. However, there are other types too:
Juvenile myoclonic epilepsy
This kind of epilepsy is often inherited in families and usually starts during the teenage years. Not like BRE, it’s considered a lifelong condition affecting the entire brain. It’s the most frequent type of epilepsy.
Individuals with juvenile myoclonic epilepsy typically have seizures shortly after a morning walk or after a nap. These seizures involve more intense tonic-clonic or brief muscle twitches seizures.
Childhood absence epilepsy
It usually affects children between 4 to 8 years old and tends to have a genetic link.
During absence seizures, a child becomes unresponsive and may gaze blankly for almost 20 seconds before suddenly returning to normal. They can have several of these seizures every day until treated with medication.
Although children with childhood absence epilepsy usually don’t experience growth delays, they may have issues with attention.
Gastaut-type childhood idiopathic occipital epilepsy
This type of epilepsy typically begins in late childhood but can start anywhere from up to 19 years. It affects both boys and girls equally.
Seizures in this form of epilepsy happen quickly and frequently, lasting less than 3 minutes. They can involve eye pain, visual hallucinations, headaches, fluttering eyelids, and temporary blindness.
Several children with this epilepsy type react well to medication like carbamazepine, and about half of them stop having seizures within 2 to 4 years.
Outlook
For a child with benign rolandic epilepsy is generally positive. In about 95 percent of cases, seizures stop happening on their own by the time the child reaches 16 years old. Most individuals with BRE experience less than 10 seizures, and about 1 out of 5 have only a single seizure in their lifespan.
If a child grows BRE at a small age, they might have more seizures and longer time of seizures. Early-onset BRE can sometimes lead to learning troubles and speech problems. However, these issues often improve as the child grows older and enters adolescence.
Summary
Childhood epilepsy alongside centrotemporal spikes, previously called as benign rolandic epilepsy, is the most frequent form of epilepsy in children, typically affecting ages 1 to 14 years. It causes seizures that often involve one side of the body and can include facial twitching, numbness, and difficulty speaking. Most children with BRE do not require treatment, but medications may be used if seizures are frequent or affect daily life.
The condition usually resolves by age 16, with many children experiencing fewer than 10 seizures or even just one in their lifetime. Early-onset BRE may lead to temporary learning and speech difficulties, but these often improve during adolescence. Overall, the prognosis for children with BRE is generally positive, with seizures typically stopping and minimal long-term effects on development.
