Benign rolandic epilepsy of childhood

Benign Rolandic epilepsy (BRE), also called benign epilepsy with centrotemporal spikes (BECTS) or benign epilepsy of childhood with centrotemporal spikes (BECCT) is the most common epilepsy syndrome in children (1,2):

• seizures originate in the Rolandic area of the brain (situated around the central sulcus of the brain, also called as centrotemporal area, located around the Rolandic fissure) (2)
  
  
• most of the affected children usually outgrow this condition by puberty, hence the term "benign”
  • typically occurs in children aged seven to ten, but may start as young as three years of age, and is twice as common in boys (1)
    
    
• incidence of BRE is 10 to 20 per 100,000 children up to age 15 years (2)
  • makes up about 15% of all epilepsy cases in children
  • adults are not affected
    
    
• speech dyspraxia and language impairments are frequent comorbidities predating the onset of seizures (1)
  • is a six times higher odds of dyslexia, which should be anticipated at diagnosis and during routine follow-up
    
    
• there is often a family history of speech and language disorders
  • Benign Rolandic epilepsy (BRE) is classified as a genetic disorder as approximately 25% of patients have a family history of either febrile seizures or epilepsy (2)
    
    
• seizure remission is universal by the age of 15 although a small but elevated risk of epilepsy in adult life remains and the risk of migraine is also increased (1,2)
  • seizures occur for only 2 to 4 years and spontaneously resolve by the age of 15 to 16 years (in more than 95% of children) (2)
  • majority of the patients have less than 10 seizures, 10% to 20% having only one seizure in their lifetime (2)
  • if early seizure onset then associated with a higher number of seizures and/or a prolonged period of seizure activity
  • if early seizure onset then this is also known to cause cognitive, behavioral, and speech abnormalities which resolve by adolescence along with resolution of seizures
  • note that BRE can be an early presentation of other epileptic syndromes

Download free parental guide from https://childhoodepilepsy.org.

Reference

1. Fisher RS, Cross JH, French JA, et al. Operational classification of seizure types by the International League Against Epilepsy: position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017 Apr;58(4):522-30.
2. Amrutkar CV, Riel-Romero RM. Rolandic Epilepsy Seizure. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-.