![]() ![]() Panayiotopoulos described a concept of benign childhood susceptibility syndrome (BCSSS) to unify RE, Panayiotopoulos syndrome (PS) and childhood occipital epilepsy of Gastaut (ICOE-G) outlined the common features, course of diseases, prognosis, and the possible genetic predisposition in this group of associated syndromes. Many studies reported that RE may cause transient or long-lasting cognitive and behavioral disturbances. There are no specific abnormalities on brain MRI or CT. Neurological and mental status before the debut of epilepsy is normal. An interictal EEG has normal background activity with biphasic high-voltage centrotemporal spikes, often followed by slow waves that are activated by sleep and tend to spread or shift from side to side. Genetic predisposition is frequent, and there is male predominance. Self-limited epilepsy with centrotemporal spikes is a syndrome of brief hemifacial motor seizures, frequently having associated somatosensory symptoms, usually without impairment of consciousness which tend to evolve into GTCS. The age of onset in 90% of cases between 1 and 10 years with a peak around 6–7 years and recovery occurs before the age of 15–16 years. The incidence range changes between 7.1–00 in a population younger than 15 years with male predominance. It is termed ‘rolandic’ epilepsy because the focal seizures are originated from the region around the lower part of the central gyrus of Rolando. Self-limited epilepsy with centrotemporal spikes (SECTS), well-known as Rolandic epilepsy is the most frequent among the childhood focal epilepsies and may account for about 15–25% of all epileptic syndromes diagnosed between the ages of 5 to 15 years. The cognitive and behavior problem may happen in active period of disease which are reversable in most of patients. The remission of seizures usually occurs before the age of 18 years. In most cases children with RE have a good prognosis regarding both seizures and neurodevelopment. The centrotemporal spikes or rolandic spikes come from the lower rolandic region created a horizontal dipole with maximal electronegativity in the centrotemporal region and electropositivity in the frontal region usually seen unilateral or bilateral. The typical interictal EEG pattern is high voltage, diphasic spikes or sharp waves frequently with slow activity on central-midtemporal region. ![]() The background activity is almost always preserved in awake state and during a sleep. The EEG picture is distinctive in Rolandic epilepsy. The characteristic clinical features are: (1) focal motor seizure with unilateral orofacial tonic or clonic contractions (2) speech arrest (3) hypersalivation (4) sensory symptoms represented by unilateral numbness or paresthesia of tongue, lips, gum and inner part of the check (5) unilateral clonic jerk in leg and arm with postictal paresis (6) generalized seizures. Seizures mainly occur during a night sleep, whereas the probability of awake seizures are less than 10%. The age of onset in 90% of cases between 1 and 10 years with peak around 6–7 years. The incidence range changes between 7.1–00 in population younger than 15 years with male predominance. Rolandic epilepsy is the most frequent among the childhood focal epilepsy and may account for about 15–25% of all epileptic syndromes diagnosed between the ages of 5 to 15 years. Many studies reported that BECTS may cause transient or long lasting cognitive and behavioral disturbances. and colleagues the term “benign” has been changed to “self-limited”. According to the new classification proposed by Sheffer I. Childhood epilepsy with centrotemporal spikes, had been previously considered as benign childhood epilepsy. ![]()
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