Benign Rolandic Epilepsy: causes, sign and symptoms, treatment

Last Updated on March 14, 2023 by Dr. Saqib Mueed

Benign Rolandic Epilepsy (BRE) is the most widely recognized type of youth epilepsy. It is alluded to as “Benign” in light of the fact that most youngsters grow out of the condition by pubescence. 

Introduction

Benign Rolandic Epilepsy (BRE) also termed as Rolandic Epilepsy is the most common epilepsy disease in children.

Most of the children have this disorder at the age of 3-13 and the disease gets its severity at the age of 8-9 years and gets checked around the age of 14-18.

The seizures start originating in the brain’s Rolandic area that result in the symptoms of this disorder.

Other names of the disorder

• Benign disorder Rolandic epilepsy 
• Benign epilepsy of centrotemporal spikes
• Benign epilepsy in children with spikes in the centrotemporal region

Types of Seizures

A seizure is a sudden feeling of electric discomfort in the different areas of the brain which ultimately causes behavioral changes, changes in movements, changes in feelings, and in the level of consciousness.

A patient suffering from two or more seizures or frequent seizures is said to be having epilepsy. However, seizures have many types depending on sensitivity.

The Rolandic epileptic patient can be categorized based on which types of seizures he is suffering from four types of seizures in this type of epilepsy.

Hemifacial sensorimotor (30% of patients):

In this type of seizure, the shock is often localized in the lower lip or takes its control to the similar hand of the body.

Motor changes are often surprising and go in continuous fashion or sudden bursts of the contractions of the clonic region. The duration of seizures can vary from a few seconds to certain minutes.

In these types of seizures, the changes in the structure of the mouth is seen as a common sign. These seizures mainly  cause numbness in the one corner of the mouth and the victim becomes unable to speak and there is excessive production of saliva.

   The sinister side of the mouth starts pulling towards the left side, and the person  unable to speak and interruption of muscular activity can also be seen in rare cases.

Oro Pharyngolaryngeal ictal manifestations (53% of patients):

These seizures include unilateral sensorimotor type symptoms inside the mouth. Numbness is most common causing tingling, pricking, and freezing.

Guttural noises can also be heard while sleeping with the patient’s mouth turned to the right side if he chews his tongue.

Strange noises like roaring also heard from such types of patients, rivers of saliva continue to fall from the patient’s mouth during the whole seizing attack and the mouth remains rigid.

Anarthria (arrest of speech) (40% of patients):

 In this type of seizure, the patient cannot speak even a single word of tangible meaning and all efforts of communication fail.

 In this type of seizure, the patient has his mouth open, wants to speak but can not and he feels that somebody is strangling him

Hypersalivation (30% of patients):

It is often characterized by hypersalivation. The patient’s mouth suddenly fills with the excessive release of saliva. The saliva runs out like a river, and he is unable to speak.

Causes

This severe disorder is named as a genetic problem as around 25% of patients have a family history of either hot seizures or severe epilepsy.

The basic cause of this is believed to be the prevailing of the autosomal genes. Nonetheless, all possible examinations indicate the function of gene study.

The cause of this disease is known. It is believed that chromosomes 11 and 15 are involved in this disease.

Most of the people suffering with disorder have been with mutations in qualities such as KCNQ2 and GRIN2A.

The disease is believed to occur due to mutations in the autosomal genes. It is an autosomal inherited disease which depends on age and variations in the gene expression are observed.

Some studies have shown that there might be variation on studies on chromosome 15 and 14, in the subunit α-7 of receptor acetylcholine. High proportion of the studies shows that the disease is due to male predominance.

Due to its less effective nature and age specific, it is believed to show a hereditary imbalance of brain maturation. It is also linked with the ELP4 gene.

Symptoms/Signs

This disease may begin at any place with ages ranging between 1- 14 years. It shows signs around 7 to 10 years in the number of cases.

This disease has stats about 15% cases in children which makes it the most well-known epilepsy disorder of adolescence. Grown-ups are not influenced.

• Pulling of face and cheeks
• Sensations in the tongue or face
• Difficulty in speaking

Mostly in cases a thing which is very noticeable is that convulsions start from the Rolandic part of the brain and travel towards the complete area of the brain. I

In this situation, the seizures are called a secondary seizure. These are also called seizures of clones. These signs are mostly dangerous.

•         Muscle contraction for short period
•         Convulsions in the body
•         After consciousness, the patient is confused

Typically, in less effective epilepsy, the seizures occur mostly at night. Due to this effect, the patients go completely unnoticed, and it can prove much dangerous.

Transmission of disease

The Rolandic Epilepsy contributes to 15 % of all of the epilepsies prevailing around the world.

• Mostly this disease’s seizure begins at the age of 6-8 but can also be seen in the children of the age of 3 to 13 they mostly affect the males rather than females
• This Syndrome Most commonly occurs in children who have a close association with relatives who are suffering from epilepsy

Diagnosis of disorder

Likewise, as you know that many other epilepsies also have several different tests in the same way the doctors also conduct the test to diagnose Rolandic epilepsy and they also prefer a thing which type and how frequent these seizures are.

EEG (electroencephalogram):

If you see this electroencephalogram then you will see the clear difference that Rolandic epileptic patients have elevations in the electroencephalogram.

 MRI (magnetic resonance imaging):

This type of test is the more advanced type of test than simple electroencephalogram in this type of test not only Rolandic epilepsy detected but also such a test need not any patient’s hist

Treatment 

• Treatment for BRE may rely upon the manifestations and seriousness in every individual.
• BRE commonly doesn’t need concentrated therapy. Because seizures might be rare and normally happen around evening time, and on account of the possible side effects of epileptic medications, numerous kids with BRE don’t take medication.
• After studying many cases it is a matter of common fact that in the long turn this disease does not have any disastrous effect on the patient’s life.
• If a patient or a child of any of the family who is suffering from such type of epilepsy, then they should consult a proper doctor. 

Facts about Rolandic Epilepsy

• A typical disorder, speaking to around 15% of all epilepsy in youngsters
• Seizures that happen when the kid is conscious include jerking, deadness, or shivering on one corner of the patient’s mouth without even losing the patient’s mental consciousness.
• The Seizures that are most likely to occur when a patient is taking rest, these types of seizures have convulsive nature and affect the body by both sides, prove more dangerous…
• Because most seizures that come across by a patient in this epilepsy happen around evening time, numerous youngsters needn’t bother with everyday ant seizure prescriptions. ^[1]https://www.seizure-journal.com/article/S1059-1311(17)30828-2/pdf^[2]Rolandic Epilepsy Seizure – StatPearls – NCBI Bookshelf (nih.gov)^[3]Population study of benign rolandic epilepsy: | Neurology^[4]Microsoft Word – Chapter 09 Koutroumanidis.docx (epilepsysociety.org.uk)

Reviewed by:

Dr. Saeed uz Zaman

MBBS, BSC (BZU), DTCD, RMP

Medical specialist in Sargodha civil Hospital

Our reviewers’ details, Click Here