Background–

Rolandic Epilepsy is the most common idiopathic partial epilepsy in childhood (10–20%) with excellent prognosis.  Age of onset is 3–13 yrs .  Family history of febrile convulsion, epilepsy or subclinical centrotemporal sharp waves may be seen in 40% of cases Seizure semiology is characterized by brief hemifacial seizures becoming generalized typically during sleep or simple partial seizure with unilateral paresthesia, tonic clonic seizures, speech arrest, and inability to swallow with drooling of saliva. EEG shows diphasic and high voltage sharp wave centrotemporal activity.  Drowsiness and slow sleep considerably increases the discharge rate.  The sharp wave activity is unilateral in majority of patients and can be bilateral and also can be outside the centrotemporal area.  Spontaneous remission with or without AEDs is the rule.  Rolandic epilepsy or Benign epilepsy of childhood with centro–temporal spikes (BECTS) has been reported with brain lesions, which are not causally related.

Objective–

To know the prevalence of rolandic epilepsy, study about its characteristics and to compare with other studies.

Methods and Observations–

Inclusion criteria–

1 Age between 1–14 years of age

2 EEG – Spikes/sharp waves at centrotemporal/frontocentral region.

3 CT/MRI – Normal or abnormality unrelated to epileptiform activity/syndrome.

Exclusion criteria

1 Age <1 yr and >14 years.

2 Non progressive encephalopathy cases with epilepsy.

3 Characteristic features of rolandic epilepsy, but interictal routine scalp EEG not suggestive of rolandic or normal.

4 Symptomatic cases.

Over a period of 2 years  2500 epileptic patients seen. Between 1–14 years of age group were 280. 30 cases included in the study. Boys and girls were equally affected. Mean age of diagnosis was 7.8 years. Hemifacial motor seizure were present in 86 % of cases and 92% become secondarily generalized, only  8% remains localized to face. 95% has excellent response. Only 2 cases needed 2 AED and 1 case on 3 AED. One of patient has recurrent attacks inspite of multiple AED

CONCLUSIONS–  

Rolandic Epilepsy is the most common idiopathic partial epilepsy in childhood. It is 5.6% of the total childhood epilepsy patients. Family history was in 20% of patients with BECTS.  It commonly presents with unilateral facial motor seizure with excess salivation and usually well controlled with monotherapy. It has a good prognosis, however a  poor outcome though uncommon, may also be seen