What is benign partial epilepsy with centrotemporal spikes?
Benign childhood epilepsy with centrotemporal spikes is the most common epilepsy syndrome in childhood. Children with rolandic epilepsy have a characteristic clinical presentation. Onset is usually in mid to late childhood with the peak age from 7-9 years.
The seizures have a focal onset usually beginning in the face, mouth and tongue. The child usually has awareness of some or all of the seizure. Seizures can generalise to tonic clonic seizures; in some cases the first seizure is a generalised seizure with the focal phase unwitnessed. The majorities of seizures (70-80%) are nocturnal and occur during sleep.
Many children with this condition are not prescribed medication, mainly because of the low frequency of seizures in most individuals (10-20% children only have one seizure), and eventual remission. If medication is given there is usually a good response. Usually the seizures cease spontaneously by puberty.
How common is it?
10-25 of childhood epilepsies are benign partial epilepsy of childhood with centrotemporal spikes. It occurs with a slightly greater incidence in boys, with onset between 3 and 13 years of age. About 30% of these children will have a family history of epilepsy.
Epilepsy and Benign Partial Epilepsy of Childhood with Centrotemporal Spikes
- Seizures appear as focal seizures with sensorimotor symptoms involving the mouth, tongue and face, such as twitching and numbness or a tingling sensation.
- Facial seizures consist of a tonic contraction of one side of the face and or clonic jerks of the cheek and eyelids.
- This may be accompanied by gutteral sounds, movements of the mouth.
- Contraction of the jaws, feelings of suffocation, profuse salivation, and a sensation inside or about the mouth.
- Sometimes an arm is involved and this is characterised by clonic jerks.
- Tonic clonic seizures may occur especially during sleep.
- Seizures characteristically occur on going to sleep or on waking from sleep.
- Daytime seizures often occur when the child is inactive or bored for example on a bus journey and the seizures are probably related to periods of dozing off.
- Seizures are usually brief in duration.
- Frequent seizures tend to occur in clusters separated by long intervals with no seizure activity.
- Seizures may be associated with short lived postictal hemiparesis (muscle weakness of one side of the body) or speech disturbance.
- Sialorrhea (excessive saliva flow) and anarthria (a loss of control of the muscles that control speech, resulting in the inability to utter words) are common.
- A variety of minor disturbances in behaviour, cognition/learning and fine motor control have been reported, particularly during the active part of the condition. These features may require specific treatment and educational approaches for some children.
- The seizures generally remit before 16 years of age.
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Bureau M, Genton P, Dravet C, Delgado-Escueta AV, Tassinari C, Thomas P, Wolf P (2012) Epileptic Syndromes in Infancy, Childhood and Adolescence. London: John Libbey.
Reviewed and updated January 2014. To be reviewed and updated January 2016.