Benign Rolandic Epilepsy
What Is Benign Rolandic Epilepsy of Childhood?
Kids with benign rolandic epilepsy of childhood (BREC) have seizures that involve twitching, numbness, or tingling of the face or tongue.
They typically happen in the early morning hours or just before bedtime. They also can happen during sleep. The seizures may stop 2–4 years after they begin, but often continue into puberty.
The term "benign" is somewhat outdated because now it is known that some of these children have learning difficulties.
What Do Seizures Look Like in Benign Rolandic Epilepsy?
The seizures in BREC (also known as benign rolandic epilepsy with centrotemporal spikes, or BECTS) are focal seizures. This means that they only happen on one side of the brain at a time. They can shift from side to side.
The seizures usually last less than 2 minutes and during one, a child will have:
- facial twitching
- numbness and tingling in the face or tongue
- drooling
- problems speaking
- if awake, full awareness during the seizure
Sometimes a BREC seizure can lead to a tonic-clonic seizure in which the whole body jerks with forceful movements.
What Causes Benign Rolandic Epilepsy?
Doctors don't know what causes benign rolandic epilepsy. Some kids with BREC may have a relative who also has epilepsy. Recently, several gene mutations were discovered in such families.
How Is Benign Rolandic Epilepsy Diagnosed?
BREC is diagnosed by a pediatric neurologist (a doctor who specializes in brain, spine, and nervous system problems). Testing may include:
- EEG, or electroencephalography (to see brain waves/electrical activity in the brain). The EEGs are often normal, but a longer test may catch a centrotemporal spike.
- VEEG, or video electroencephalography (EEG with video recording)
- MRI scans to look inside the brain (the results usually are normal)
How Is Benign Rolandic Epilepsy Treated?
There is some debate as to whether children with benign rolandic epilepsy need treatment. In some European countries, doctors often choose not to treat the condition.
Many pediatric neurologists use a low-dose seizure medicine to treat BREC. Before stopping the medicine when a child reaches puberty, doctors usually order a 24-hour VEEG recording to make sure the centrotemporal spikes are gone.
How Can I Help My Child?
If your child takes medicine, make sure you give it exactly as directed. Also help your child avoid known seizure triggers such as lack of sleep or the use of antihistamine medicines (such as Benadryl).
Some children with BREC have learning or behavior problems during the years that they have seizures. While this usually goes away after the child stops having seizures, get help from specialists early on to support academic and emotional success.
No special care is needed during a typical BREC seizure. But because a BREC seizure can lead to a tonic-clonic seizure, make sure that you and other adults and caregivers (family members, babysitters, teachers, coaches, etc.) know what to do if one happens.