Benign Rolandic epilepsy (BRE) is also known as benign epilepsy with centro-temporal spikes (BECTS). It is the most common form of childhood epilepsy, characterized by seizures originating from the Rolandic region of the brain. Seizures in BRE are focal and unilateral with preserved consciousness. Common presentations of BRE-related seizures include unilateral facial twitching and paresthesias, speech arrest, gurgling, and excessive salivation. Most seizures are self-limited and abort in less than 3 minutes. In some cases, seizures may spread to involve the ipsilateral arm and leg and may even generalize with loss of consciousness. Seizures typically occur at night or upon awakening, and this nocturnal pattern often leads to episodes going unnoticed and a delayed diagnosis.
Children with a family history of BRE or febrile seizures are at higher risk of developing BRE. No specific gene mutations for development of BRE have yet been identified. BRE occurs in 10-20 per 100 000 children younger than 15 years. Onset of seizures occurs between the ages of 1-14 years, with a peak in later childhood from ages 7-10 years. Boys are affected more frequently than girls, with a ratio of 1.5:1.
BRE-related seizures typically occur for only 2-4 years, with most children having fewer than 10 lifetime seizures. Ninety-five percent of children will outgrow BRE by the age of 16 years.