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What Is Benign Rolandic Epilpesy?

According to Epilepsy Action, benign rolandic epilepsy, also known as benign rolandic epilepsy (BRE) of childhood (BREC) or benign epilepsy with centro-temporal spikes (BRECTS), is one of the most common types of epilepsy found in children, affecting every one in five cases. Benign rolandic epilepsy is an epilepsy syndrome (signs and symptoms that suggest a particular condition) that typically affects children from 3 to 10 years of age and goes into complete remission by the time the child reaches puberty (14 to 18 years).

  1. Symptoms

    • BRE symptoms often present during the night or upon waking. The seizure will typically begin as a numbness or tingling sensation on one side of the mouth, affecting the lips, gums, tongue and inside of the cheek. If the seizure spreads to the throat, it may affect the child's ability to speak clearly. The child may vocalize odd throaty noises or gurgling sounds, and he may drool. He may also experience clonic (twitching) and/or tonic (stiffness) on one or both sides of his face, and this may spread to his arms and legs. If the clonic and tonic movement occurs on both sides (called a tonic-clonic seizure), the child will probably lose consciousness and urinary control. The entire event will last for two to three minutes. Following a tonic-clonic seizure, a child may sleep for several hours.

    Cause

    • BRE seizures occur in the rolandic part of the brain, specifically in the rolandic strip in the front of the temporal lobe responsible for certain motor functions. Until recently, BRE was considered to be idiopathic (of unknown cause) in nature. However, a recent Columbia University study (1999) revealed a genetic marker for BRE: a mutation of the ELP4 gene. Scientists believe that the ELP4 gene may be responsible for patterns of neuron activity and transmission during brain development, thereby producing the "temporary glitch" which presents as benign rolandic epilepsy.

    Diagnosis

    • The child's doctor will record a thorough and precise history of the child's seizure(s) and do a complete neurological exam. She may opt to perform an MRI, which will be normal in children with BRE. She will then perform an electroencephalogram (EEG), a test that records electrical activity in the brain. The EEG should be able to confirm epileptic activity in the rolandic strip.

    Treatment

    • Because BRE seizures are typically infrequent and nocturnal, children with BRE usually do not require medication. However, if a child is prone to frequent nighttime seizures, or has daytime seizures, a mental handicap or a learning disorder, an anti-epileptic drug may be prescribed. Drugs used to control BRE seizures include carbamazepine, gabapentin, lamotrigine, sodium valproate and oxcarbazepine. Medication is typically taken daily for a period of two years.

    Prognosis

    • The prognosis for children with BRE is excellent, as they will outgrow it by the time they reach young adulthood when the "temporary glitch" works itself out. According to Epilepsy Action, some children with BRE experience difficulty in school with language and learning, although most cope very well and problems are minimal.

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