Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Rolandic epilepsy is a seizure disorder that affectsyoung childrenand adolescents. It is also called benign rolandic epilepsy (BRE) of childhood, epilepsy with centrotemporal spikes, or benign partial epilepsy of childhood. Children with this condition have mild seizures that cause twitching, tingling,or numbness of the face and tongue.
Children with BRE don’t typically develop lifelong epilepsy or have any associated neurological impairment. The condition generally resolves during the teenage years.
This article discusses benign rolandic epilepsy, what causes it, and how it can be controlled.
Jessica Olah / Verywell
Symptoms of Rolandic Epilepsy
BRE seizures last for a few seconds at a time. They manifest with face and lip twitching and/or a tingling sensation in the mouth and lips. Some children drool or make involuntary throat noises during the episodes.
Your child may also experience impairment of consciousness during the seizures—but often, children are completely awake and fully alert throughout the episodes.
The seizures often occur during sleep. Children do not usually wake up during a seizure, and, sometimes the episodes can go completely unnoticed. While uncommon, the seizures maygeneralize, which means that they can involve shaking and jerking of the body, as well as impairment of consciousness.
Children with BRE typically experience a few seizures throughout their whole childhood. The seizures generally stop during the teenage years. However, there are exceptions, and some children may experience other types of seizures, have frequent seizures, or continue to have seizures during adulthood.
Associated Symptoms
Generally, kids with BRE are healthy, but some children with the condition have speech or learning difficulties. While it is not common, children can have behavioral or psychological issues as well.
There is a strong association between BRE and central auditory processing disorders (CAPDs). In fact, one study found that 46% of children with BRE had CAPDs, which causes problems with hearing, understanding, and communication.CAPDs could be the cause of learning and speech difficulties, as well as some of the behavioral and psychological issues.
There is also an association between BRE andchildhood migraines, and the cause and frequency of this link is not fully understood.
What Causes Rolandic Epilepsy?
BRE is described as idiopathic epilepsy, which means that it isn’t known why a person develops it. This condition is not associated with any type of trauma or other identifiable predisposing life factor.
Some experts have proposed that the seizures seen in BRE are related to incomplete maturation of the brain, and suggest that brain maturation is the reason the seizures stop in late adolescence.
Genetics
There may be agenetic componentto BRE and most kids with the condition have at least one relative with epilepsy.
Epilepsy is diagnosed based on the clinical history as well as the EEG. If your child has had seizures, their healthcare provider will do a physical examination to determine if the child has any neurological deficits, such as weakness of one side of the body, hearing loss, or speech problems.
Your child may also have some diagnostic tests, such as anelectroencephalogram(EEG)or brain imaging tests.
EEG
An EEG is a non-invasive test that detects the electrical activity of the brain.
Your child will have several metal plates (each about the size of a coin) placed on the outside of their scalp. The metal plates are each attached to a wire, and the wires are all plugged into a computer, which produces a tracing on paper or on the computer screen.
The tracing should appear as rhythmic waves that correspond to the location of the metal plates in the scalp. Any change in the typical wave rhythm can give your child’s healthcare provider an idea about whether your child has seizures and how they can be treated.
With BRE, the EEG typically shows a pattern described asrolandic spikes, which are also called centrotemporal spikes.These are sharp waves that indicate seizure tendency in the area of the brain that controls movement and sensation. The spikes can become more prominent during sleep.
Seizures that occur during sleep can often be identified with an EEG test. If your child has a seizure during an EEG, this suggests that seizures could be occurring at other times as well.
What Is a Sleep-Deprived EEG for Seizures?
Brain Imaging
There is also a high likelihood that your child will have a braincomputerized tomography (CT)ormagnetic resonance imaging (MRI), which are noninvasive tests that produce a visual image of the brain.
A brain MRI is more detailed than a brain CT, but it takes about an hour, while a brain CT only takes a few minutes. A brain MRI must be done in an enclosed space, which feels like a small tunnel. For these reasons, your child may not be able to sit still through an MRI exam or handle the feeling of being enclosed in an MRI machine, making a CT an easier option.
These imaging tests can identify problems, such as previous head trauma or other anatomical variants that can cause seizures.
Typically, brain imaging tests are normal in BRE.
There are no blood tests that can confirm or eliminate the diagnosis of BRE, so your child will only need blood tests if your healthcare provider is concerned about other medical problems, such as metabolic conditions.
Differential Diagnosis
There are a few conditions that can produce involuntary muscle moments, and they may seem similar to rolandic epilepsy, especially when your child’s symptoms are just beginning, or if you have not been able to observe them yourself.
The difference between absence seizures and rolandic seizures is that absence seizures usually don’t involve motor movements (but they can include lip smacking or eyelid fluttering), while rolandic seizures don’t typically involve altered consciousness.
However, since there can be some similarities and confusion between the conditions, an EEG can differentiate them. The EEG of absence seizures should show changes in the wave appearance throughout the brain, not just in the centrotemporal region.
Generally, tics can be suppressed for a few minutes, while seizures cannot. Tics are not associated with the EEG brain wave characteristics of seizures.
Congenital metabolic illness: Some hereditary conditions can make it difficult for your child to metabolize common nutrients, and may manifest with twitches or changes in consciousness. For example, lysosomal storage disorders andWilson’s diseasecan cause some symptoms that can overlap with those of BRE.
Usually, metabolic diseases also produce other symptoms, including motor weakness. Often, blood tests or genetic tests can distinguish between rolandic epilepsy and metabolic disorders.
How Rolandic Epilepsy Is Controlled
There are treatments for rolandic epilepsy. However, the symptoms can be so mild that treatment is often unnecessary.
If your child has frequent seizures, it may be beneficial for them to take anticonvulsants. And if the symptoms involve jerking of the arms or legs, falling, loss of bowel or bladder control, or impairment of consciousness, anti-seizure medication is often considered.
The most common anti-seizure treatments used for rolandic epilepsy are Tegretol (carbamazepine), Trileptal (oxcarbazepine), Depakote (sodium valproate), Keppra (levetiracetam), and sulthiame.
If your child has other types of seizures in addition to rolandic seizures, then their healthcare provider will prescribeanticonvulsantsto control other seizure types—and this may also completely control rolandic epilepsy.
Most of the time, since children outgrow rolandic epilepsy before adulthood, medication can eventually be discontinued. However, be sure not to stop you child’s anticonvulsants yourself, as abrupt discontinuation can trigger a seizure.
Your child’s healthcare provider may re-evaluate the condition and might order another EEG before gradually tapering the medication.
In coping with the condition, it may help to join anepilepsy support group.
Summary
Benign rolandic epilepsy is a childhood form of epilepsy that causes mild seizures, usually in the face and/or tongue. These seizures often happen during sleep though they can also happen during the day. Most children with this condition will stop having seziures in their teens.
Many people with rolandic epilepsy don’t require treatment. If the person has frequent seizures or symptoms like jerking of the arms and legs, falling, or loss of bladder control, anticonvulsant medication may be prescribed.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Matos M, Bara T, Clark S, Zeigelboim BS, Marques JM, Liberalesso PBN.Benign rolandic epilepsy of childhood and central auditory processing disorder: A noncasual neurophysiological association.Epilepsy Behav.2018;(89):55-58. doi:10.1016/j.yebeh.2018.06.039American Association of Neurological Surgeons.Epilepsy.Liu Z, Ye X, Qiao P, et al.G327E mutation in SCN9A gene causes idiopathic focal epilepsy with Rolandic spikes: a case report of twin sisters.Neurol Sci.2019;40(7):1457-1460. doi:10.1007/s10072-019-03752-3Rajeswari S, Jayapriyanjali J.A case report on rolandic epilepsy.Pond J Nurs. 2021 Aug 6;14(2):48-50. doi:10.5005/jp-journals-10084-13109Gu W, Chen J, Tian W, et al.Outcome analysis of children with rolandic discharges on EEG: A real-world study.Seizure. 2020;82:105-108. doi:10.1016/j.seizure.2020.09.012Epilepsy Foundation.Absence seizures.National Institute of Neurological Disorders and Stroke.Tourette syndrome.Mellish LC, Dunkley C, Ferrie CD, et al.Antiepileptic drug treatment of rolandic epilepsy and Panayiotopoulos syndrome: clinical practice survey and clinical trial feasibility.Arch Dis Child.2015;100(1):62-67. doi:10.1136/archdischild-2013-304211Additional ReadingEpilepsy Foundation.Childhood epilepsy centrotemporal spikes (benign rolandic epilepsy).Xiong W, Zhou D.Progress in unraveling the genetic etiology of rolandic epilepsy. Seizure. 2017;(47):99-104. doi:10.1016/j.seizure.2017.02.012
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Matos M, Bara T, Clark S, Zeigelboim BS, Marques JM, Liberalesso PBN.Benign rolandic epilepsy of childhood and central auditory processing disorder: A noncasual neurophysiological association.Epilepsy Behav.2018;(89):55-58. doi:10.1016/j.yebeh.2018.06.039American Association of Neurological Surgeons.Epilepsy.Liu Z, Ye X, Qiao P, et al.G327E mutation in SCN9A gene causes idiopathic focal epilepsy with Rolandic spikes: a case report of twin sisters.Neurol Sci.2019;40(7):1457-1460. doi:10.1007/s10072-019-03752-3Rajeswari S, Jayapriyanjali J.A case report on rolandic epilepsy.Pond J Nurs. 2021 Aug 6;14(2):48-50. doi:10.5005/jp-journals-10084-13109Gu W, Chen J, Tian W, et al.Outcome analysis of children with rolandic discharges on EEG: A real-world study.Seizure. 2020;82:105-108. doi:10.1016/j.seizure.2020.09.012Epilepsy Foundation.Absence seizures.National Institute of Neurological Disorders and Stroke.Tourette syndrome.Mellish LC, Dunkley C, Ferrie CD, et al.Antiepileptic drug treatment of rolandic epilepsy and Panayiotopoulos syndrome: clinical practice survey and clinical trial feasibility.Arch Dis Child.2015;100(1):62-67. doi:10.1136/archdischild-2013-304211Additional ReadingEpilepsy Foundation.Childhood epilepsy centrotemporal spikes (benign rolandic epilepsy).Xiong W, Zhou D.Progress in unraveling the genetic etiology of rolandic epilepsy. Seizure. 2017;(47):99-104. doi:10.1016/j.seizure.2017.02.012
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Matos M, Bara T, Clark S, Zeigelboim BS, Marques JM, Liberalesso PBN.Benign rolandic epilepsy of childhood and central auditory processing disorder: A noncasual neurophysiological association.Epilepsy Behav.2018;(89):55-58. doi:10.1016/j.yebeh.2018.06.039American Association of Neurological Surgeons.Epilepsy.Liu Z, Ye X, Qiao P, et al.G327E mutation in SCN9A gene causes idiopathic focal epilepsy with Rolandic spikes: a case report of twin sisters.Neurol Sci.2019;40(7):1457-1460. doi:10.1007/s10072-019-03752-3Rajeswari S, Jayapriyanjali J.A case report on rolandic epilepsy.Pond J Nurs. 2021 Aug 6;14(2):48-50. doi:10.5005/jp-journals-10084-13109Gu W, Chen J, Tian W, et al.Outcome analysis of children with rolandic discharges on EEG: A real-world study.Seizure. 2020;82:105-108. doi:10.1016/j.seizure.2020.09.012Epilepsy Foundation.Absence seizures.National Institute of Neurological Disorders and Stroke.Tourette syndrome.Mellish LC, Dunkley C, Ferrie CD, et al.Antiepileptic drug treatment of rolandic epilepsy and Panayiotopoulos syndrome: clinical practice survey and clinical trial feasibility.Arch Dis Child.2015;100(1):62-67. doi:10.1136/archdischild-2013-304211
Matos M, Bara T, Clark S, Zeigelboim BS, Marques JM, Liberalesso PBN.Benign rolandic epilepsy of childhood and central auditory processing disorder: A noncasual neurophysiological association.Epilepsy Behav.2018;(89):55-58. doi:10.1016/j.yebeh.2018.06.039
American Association of Neurological Surgeons.Epilepsy.
Liu Z, Ye X, Qiao P, et al.G327E mutation in SCN9A gene causes idiopathic focal epilepsy with Rolandic spikes: a case report of twin sisters.Neurol Sci.2019;40(7):1457-1460. doi:10.1007/s10072-019-03752-3
Rajeswari S, Jayapriyanjali J.A case report on rolandic epilepsy.Pond J Nurs. 2021 Aug 6;14(2):48-50. doi:10.5005/jp-journals-10084-13109
Gu W, Chen J, Tian W, et al.Outcome analysis of children with rolandic discharges on EEG: A real-world study.Seizure. 2020;82:105-108. doi:10.1016/j.seizure.2020.09.012
Epilepsy Foundation.Absence seizures.
National Institute of Neurological Disorders and Stroke.Tourette syndrome.
Mellish LC, Dunkley C, Ferrie CD, et al.Antiepileptic drug treatment of rolandic epilepsy and Panayiotopoulos syndrome: clinical practice survey and clinical trial feasibility.Arch Dis Child.2015;100(1):62-67. doi:10.1136/archdischild-2013-304211
Epilepsy Foundation.Childhood epilepsy centrotemporal spikes (benign rolandic epilepsy).Xiong W, Zhou D.Progress in unraveling the genetic etiology of rolandic epilepsy. Seizure. 2017;(47):99-104. doi:10.1016/j.seizure.2017.02.012
Epilepsy Foundation.Childhood epilepsy centrotemporal spikes (benign rolandic epilepsy).
Xiong W, Zhou D.Progress in unraveling the genetic etiology of rolandic epilepsy. Seizure. 2017;(47):99-104. doi:10.1016/j.seizure.2017.02.012
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