Benign Epilepsy of Childhood With Rolandic Spikes

Abstract

Summary Twenty‐six cases of “benign epilepsy of childhood” with Rolandic spikes, thoroughly studied clinically and electroencephalographically, were compared with 26 patients with petit mal or petit mal and grand mal seizures. Absences could be detected in a fair number of children with “benign epilepsy.” Rolandic spikes and MU rhythms were found almost exclusively in patients having convulsions, whether focal or generalized. Rolandic spikes associated with MU rhythms and bilaterally synchronous or asynchronous discharges of spikes or of spike‐and‐slow‐waves seem, therefore, to be the features of an epilepsy whose clinical manifestations (absences or convulsions) may depend on the psycho‐biophysiological background. RÉsumé 26 cas d' “Epilepsie bénigne de L'enfance avec pointes Rolandiques” ont étéétudiés du point de vue clinique et électroencéphalographique, ils sont compareés à 26 observations de patients présentant des crises petit mal, ou petit mal et grand mal associées. Les absences petit mal électrocliniques sont fréquentes chez les sujets porteurs d'une épilepsie bénigne de L'enfance. Les pointes Rolandiques et les rythmes MÛ sont exclusivement enregistrés chez les patients présentant des crises convulsives focales ou et généralisées. L'association pointes Rolandiques, rythme MÛ, décharges bilatérales de pointes ou de pointes ondes, synchrones ou asynchrones, semble caractéristique des épilepsies bénignes dont la forme convulsive ou nonconvulsive dépend des conditions psycho‐biophysiologiques actuelles. ZUSAMMEnfassung 26 vollständig klinisch und elektroencephalographisch untersuchte Fälle von kindlicher benigner Epilepsie mit Rolandischen spikes, wurden mit 26 Kindern mit Petit‐Mai oder Petit‐Mal und Grand‐Mal verglichen. In einer beträchtlichen Anzahl von Kindern mit benigner Epilepsie konnten Absencen beobachtet werden. Rolandische spikes und MU‐Rhythmen wurden fast ausschliesslich bei Patienten mit fokalen oder generalisierten Anfällen gefunden. Das gemeinsame Auftreten von Rolandischen spikes, MU‐Rhythmen und bilateral synchronen oder asynchronen Entladungen von spikes oder spike‐slow‐waves scheinen somit Zeichen einer Epilepsie zu sein, deren klinische Manifestation (Absencen oder Krampfanfälle) vom psycho‐biophysiologischem Hintergrund abhängen. RESUMEN Se han comparado 26 casos de “epilepsyía benigna del niño con puntas Rolándicas,” concienzudamente estudiados clínica y electroencefalográficamente con 26 enfermos que padecían episodios de petit‐mal o ataques de gran mal asociados a petit‐mal. Se recogieron ausencias en un considerable número de niños con “epilepsyía benigna.” Puntas Rolándicas y ritmos MU se encontraron exclusivamente con convulsiones, ya fueran focales o generalizadas. La asociación de puntas Rolándicas, ritmos MU y descargas bilaterales síncronas o asíncronas, de puntas o punta‐onda lenta parece ser un hallazgo de las epilepsyías cuyas manifestaciones clínicas (ausencias o convulsiones) pueden depender de un fondo psico‐biofisiológico.

Landau–Kleffner syndrome, electrical status epilepticus in slow wave sleep, and language regression in children

“…The vertical dipole seen in LKS distinguishes it from the centrotemporal spikes seen in benign Rolandic epilepsy, which have a horizontal dipole [Baumgartner et al, 1996;Gregory and Wong, 1984;van der Meij et al, 2001]. In Rolandic epilepsy there is an increase in the centrotemporal spike activity in sleep [Beaumanoir et al, 1974;Blom and Heijbel, 1975;Dalla Bernardina et al, 2002] similar to the increase in electroencephalographic activity found in LKS and ESES. The clinical syndrome is usually benign.…”

“…The clinical syndrome is usually benign. There have been isolated case reports of evolution from Rolandic epilepsy to LKS, but it is unclear whether those cases of Rolandic epilepsy were "typical" [Beaumanoir et al, 1974;Cole et al, 1988]. There is some debate as to whether the variability of EEG findings in LKS are due to the variability of the syndrome and the unclear relationship between the EEG abnormalities and the underlying pathophysiology or whether the variability simiply reflects the timing at which recordings were done in relation to the onset of symptoms [Holmes et al, 1981;Tassinari et al, 2002].…”

Benign partial epilepsy and related conditions: Multifactorial pathogenesis with hereditary impairment of brain maturation

“…Benign epilepsy with centrotemporal sharp waves (rolandic epilepsy) [7,17,55] The most characteristic manifestations are focal sensomotor seizures, particularly in the cephalic region, as well as unilateral and generalized tonic-clonic attacks. The seizures are usually accompanied by sialorrhoea, and often by speech arrest or dysarthria.…”

Benign Partial Epilepsy with Centrotemporal (or Rolandic) Spikes and Brain Lesion

“…In case 1 , generalized spike waves (SWs) appeared during sleep; this has been shown to happen in BECT (Beaumanoir et al, 1974); the same may be said about the occipital spikes noted in case 2 (Beaussart, 1972). In case 1 , generalized spike waves (SWs) appeared during sleep; this has been shown to happen in BECT (Beaumanoir et al, 1974); the same may be said about the occipital spikes noted in case 2 (Beaussart, 1972).…”