Mahmoud Reza Ashrafi

Professor of Pediatric Neurology , Children’s Medical Center , Tehran University of Medical Sciences

Benign childhood focal seizures and epileptic syndromes are one of  the most common seizure disorders of children and  affect 25% of cases  with nonfebrile seizures of this age group .

The three most common and recognized syndromes of idiopathic childhood focal epilepsies are

1. benign childhood epilepsy with centrotemporal spikes (BCECTS)
2. early onset benign childhood occipital epilepsy (Panayiotopoulos type)
3. late-onset childhood occipital epilepsy (Gastaut type) .

BCECTS or rolandic seizures is the most common manifestation of benign childhood seizures with excellent prognosis and remission within 2–4 years of onset . Onset is from age 1 to 14 years and peak  age of 8 or 9 years.The cardinal clinical manifestations of rolandic seizures are infrequent, often single, focal seizures of facial muscles with sensorimotor symptoms , oropharyngolaryngeal manifestations, speech arrest and drooling . BCECTS is a genetic epilepsy with autosomal dominant inheritance . Except  the EEG, all paraclinical findings including brain imaging  are normal. In inter-ictal EEG , central temporal spikes  are the hallmark of BCECTS . In some children with rolandic seizures , particularly if the seizures are infrequent, mild or nocturnal, may be no need for therapy . Carbamazepine is the preferred AED and Levetiracetam seems to be highly effective.