Benign rolandic epilepsy (BRE) in children

Benign rolandic epilepsy (BRE) is a form of epilepsy. In this condition, convulsions affect the face and sometimes the body. As a result, the disorder causes problems for some children. However, it almost always disappears during adolescence.

Who gets BRE?

BRE accounts for approximately 15% of epilepsy cases in children. On average, children are 6 to 8 years old when they first develop benign rolandic epileptic seizures. However, adults do not suffer from this form of epilepsy.

It is called "rolandic" because the seizures occur in the rolandic area of the brain. This is the area that controls the face. Because these seizures start in a specific part of the brain, they are called partial seizures.

BRE is also called "benign childhood epilepsy with centrotemporal spikes". This refers to the pattern of brain waves he often creates on an electroencephalogram.

What causes BRE?

Nobody knows what causes BRE. Children who have close relatives with epilepsy are slightly more likely to develop the condition.

What are the symptoms of BRE?

Like all forms of epilepsy, BRE causes seizures. Benign rolandic epileptic seizures are usually mild. They usually start on the face and can take many forms:

face or cheek twitching
tingling, numbness, or unusual sensations in the tongue or face
difficulty speaking
drooling due to inability to control the mouth muscles

In about one in two children with BRE, seizures spread from the rolandic area to the rest of the brain. In this case, the seizure is called secondary-generalized. They are also called tonic-clonic seizures. Their symptoms are more worrisome to see:

unresponsiveness
clenching of muscles all over the body for a short period
rhythmic convulsions of the whole body
confusion and disorientation upon regaining consciousness

As a rule, in BRE, seizures occur during sleep. For this reason, they may not be noticed at all. In other cases, parents witness a seizure after examining nighttime noises in their child's room.

Some children with BRE may also have:

learning difficulties
behavioral problems

These children with BRE may require additional attention and treatment.

What tests are used to diagnose BRE?

When seizures are mild and occur only during sleep, BRE can easily go undiagnosed. Often, parents bring their child to the doctor after a tonic-clonic seizure in their sleep.

Doctors diagnose BRE based on the nature of the seizures. They also collect information from several tests:

Electroencephalogram: By attaching a set of adhesive electrodes to the scalp, the technician records brain waves during this painless test. The neurologist interprets the electroencephalogram. Children with BRE often have spikes on EEG recordings that help in making a diagnosis.
Magnetic resonance imaging: This high-resolution brain scan is normal for children with BRE. Getting an MRI is noisy and can be distressing, but it's painless.
Neurological examination: Children with BRE usually have a normal neurological examination.

What are the treatments for BRE?

Often in BRE, no treatment is required or recommended. BRE seizures are usually mild, harmless, and infrequent. Almost all children outgrow this condition.

Children may benefit from treatment if they have any of the following problems with BRE: