This is an epilepsy syndrome that commonly affects the children around the age of 6-8 presenting signs such as twitching or numbness of the face and the tongue that can interfere with their ability to talk. This is named rolandic as it is associated with the part of the brain known as the rolandic area which is also the centro-temporal region of the brain’s surface. Most of the seizure types are partial as only this part of the brain is involved. It is estimated that around 1 in 5 children with epilepsy will present the benign rolandic epilepsy. The children with the benign rolandic epilepsy mostly outgrow the condition during their puberty. In most cases, the seizure only occurs at night and does not last more than a few minutes. The seizures can spread and become generalized seizures.
Causes
Rolandic epilepsy is thought to be a genetic disorder where research indicates that certain parts of chromosome 11 and chromosome 15 may be involved in developing this syndrome although a specific gene has not yet been recognized.
Symptoms
The seizure typically occurs in the nighttime or when the children are just about to wake up presenting signs such as twitching and facial stiffness. The tingling sensation may develop on one side of the mouth such as the tongue, lips or within the cheeks. When the seizure affects the mouth, speech difficulties can be evident making it hard to understand the individual. When both sides of the body become involved, this can create jerking movements of the limbs, stiffness and loss of consciousness. This is known as the tonic-clonic seizure which is a generalized seizure. In addition, some of these individuals may experience migraines, loss of bladder control, learning difficulties and behavioral problems.
Diagnosis
The diagnosis is based on the history of the seizure and an EEG test which records the electrical activity of the brain. Children with this condition usually show epileptic activity in the rolandic part of the brain. Although some of the cases may have a normal EEG, this doesn’t rule out the possibility of epilepsy. In such cases, a sleep-deprived EEC recording may be required which may present the abnormal activity of the brain.
Treatment
Generally, medications for seizures are not necessary as they are infrequent and usually subside by the early adolescence. However, in some cases, medications may be required if seizures interfere with their sleep, create reading disability or can occur in the daytime. Most of the cases respond to one type of medication, however, some cases may require a combination of different medications.
Prognosis
The prognosis for these affected children appears good. Although most of the cases are resolved by the time they reach puberty, some rare cases may relapse in adulthood. Research indicates that developmental and behavioral problems might continue even when the seizure ceases.
References
http://www.epilepsy.com/learn/types-epilepsy-syndromes/benign-rolandic-epilepsy
https://www.epilepsy.org.uk/info/syndromes/benign-rolandic-epilepsy
https://rarediseases.info.nih.gov/diseases/10287/benign-rolandic-epilepsy-bre/cases/21582
