What is Rolandic Syndrome?

Rolandic Syndrome, or benign childhood epilepsy with centrotemporal spikes (BCECTS), is a seizure disorder that exhibits epileptic seizures during the childhood years. It is known as Rolandic epilepsy because the seizures take place mainly in the area of the brain known as the Rolandic area, which spans the lower part of the middle frontal lobe. The seizures experienced in this condition are typically focal, meaning that they are isolated to one area of the brain and body, with many described as having a “tingling” or “pins and needles” sensation in the feet or hands.

These seizures generally occur just after the person wakes up in the morning or falls asleep in the evening, and usually last a few seconds. While they are brief in duration, they may recur several times throughout the day. Rolandic seizures usually begin in early childhood (ages 3-13) and typically subside in late childhood, after which they are unlikely to reoccur. Nonetheless, this form of epilepsy remains a source of concern to the patient and family due to the possibility of recurrences.

Symptoms of Rolandic Syndrome

The most common symptom of Rolandic Syndrome is the occurrence of epileptic seizures, which may be accompanied by other symptoms depending on the intensity of the seizure. These additional symptoms can include weakness or even full-body paralysis temporarily. Speech difficulty is also possible, as well as drowsiness or confusion after the seizure has ended.

Parents will often notice that their child has difficulty speaking or understanding language during or after a seizure. This partial “aphasia” is due to the temporary disconnection between areas of the brain that control language. This symptom is often accompanied by a drooping face and difficulty moved the arms or legs.

Diagnosis and Treatment of Rolandic Syndrome

In order to diagnose and treat Rolandic Syndrome, your doctor will carefully review your child's medical history, symptoms, and family history. An EEG, or electroencephalogram is recommended to aid in the diagnosis of this condition. This test looks for irregularities in the electrical activity of the brain, allowing the doctor to pinpoint exactly where the seizures are originating from. Depending on the severity of the case, medication may be prescribed to help reduce the occurrence of seizures.

One of the most important things to remember with Rolandic Syndrome is that most cases will resolve on their own with little to no treatment. Your doctor can discuss the best course of action for your child, depending on the symptoms. In some cases, lifestyle modifications may be recommended, such as sticking to a regular sleep schedule, reducing stress, and avoiding caffeine and alcohol.

Outlook on Rolandic Syndrome

Rolandic Syndrome can be a frightening and confusing time for children and parents alike. However, it is important to recognize that it is usually a mild form of epilepsy and is easily managed with the right medical care and lifestyle changes. With regular monitoring and care, most children will outgrow these seizures by late childhood. It is also important to be aware that while recurrences are possible, they also become less frequent and less intense over time.

Overall, it is important to keep in mind that children with Rolandic Syndrome may have better long-term outcomes if they are treated quickly and appropriately with the guidance and support of a medical professional.