What is Benign Rolandic Epilepsy?

Benign rolandic epilepsy, also known as benign childhood epilepsy with centrotemporal spikes (BECTS), causes seizures that occur during sleep. Other names for benign rolandic epilepsy are:

  • Childhood epilepsy with centrotemporal spikes
  • Self-limited epilepsy with centrotemporal spikes (SeLECTS)

The term “benign” refers to the fact that all children outgrow these seizures by their teenage years. “Centrotemporal spikes” refers to the abnormal spikes of electrical activity that occur in the brain. The spikes appear in the centrotemporal or “rolandic” region of the brain. This area controls movement in the face, mouth and throat.

Benign rolandic epilepsy seizures typically begin between the ages of 6 and 12. Benign rolandic epilepsy accounts for about 15% of all epilepsies in children. It does not affect adults.

Children with benign rolandic epilepsy are usually otherwise healthy.

Benign Rolandic Epilepsy Symptoms

Benign rolandic epilepsy is the most common type of focal epilepsy in children. Focal epilepsy means the seizure activity begins in one part of the brain. The seizure activity may spread to the other side of the brain. The seizures are brief. They usually last less than two minutes.

Most seizures happen at night as a child falls asleep or wakes up. Seizures may occur while fully awake or during the day when the child naps or falls asleep while doing a relaxing activity (such as watching TV or reading). This isn’t as common.

Symptoms can include:

  • A tingly or numb sensation in the face, mouth or tongue.
  • Drooling.
  • Trouble speaking.
  • Incontrollable twitching or jerking of the face or arms.

The seizure usually affects one-half of the face, arm or leg. If the child is awake or wakes up during the seizure, they may be aware of what is happening. Some children don’t remember the seizure, or they sleep through it.

Focal seizures can progress to a full body “grand mal” seizure. In a “grand mal” seizure, the child’s muscles stiffen. Their arms and legs jerk uncontrollably.

After a seizure, the child may be tired or confused for a little while. They may have short term weakness in the face or upper arm.

Benign Rolandic Epilepsy Causes

Experts aren’t sure what causes benign rolandic epilepsy. Some children have a family history of the condition. Many do not have a family history.

Benign Rolandic Epilepsy Diagnosis

If a child has focal seizures at night and is 6 to 12 years old, benign rolandic epilepsy is a likely cause. To confirm the diagnosis, your child’s doctor will do a complete neurological exam. They will ask you and your child to describe the seizures.

The doctor will order an electroencephalography (EEG) test that takes place while your child is awake and sleeping. An EEG measures electrical activity in the brain. If a child has benign rolandic epilepsy, the EEG results will show a specific pattern of electrical activity in the centrotemporal region of the brain.

Benign Rolandic Epilepsy Treatment

Doctors do not always prescribe anti-seizure medication for children with benign rolandic epilepsy. This is because the seizures:

  • Are infrequent
  • Usually happen at night when a child is safe in bed
  • Typically go away on their own

Your child’s doctor may prescribe anti-seizure medicine if there are several seizures, or they occur while awake.

Benign Rolandic Epilepsy Prognosis

Benign rolandic epilepsy does not cause long-term problems with learning or intelligence. About 95 percent of children with benign rolandic epilepsy stop having seizures by age 15.


Source: cincinnatichildrens.org, Jeffrey Tenney, MD, PhD