Centrotemporal epilepsy, also known as benign rolandic epilepsy, is a form of epilepsy where seizures affect the face and sometimes the body. This form of epilepsy does not affect adults, and seizures typically begin in affected children around the age of six to eight years old.
"Rolandic" refers to the region of the brain in which the seizures begin; this area of the brain is what controls the face. Rolandic seizures are considered "partial" seizures because they begin in a specific region of the brain rather than involving the entire brain. The seizures resulting from centrotemporal epilepsy are generally mild, and may include facial or cheek twitching, numbness or tingling in the tongue or face, difficulty speaking, and drooling due to the inability to not be able to control the mouth temporarily. Many times, rolandic seizures occur during sleep, so they may go unnoticed. Children with rolandic epilepsy may also have learning difficulties and behavioral issues.
In about half of children with this condition, the seizures begin in the rolandic region of the brain, but then spread to the rest of the brain. This is referred to as secondary generalized seizures (or tonic-clonic seizures) and symptoms are more severe and include full body muscle clenching, convulsions, unresponsiveness, and confusion or disorientation after the seizure is over.
Diagnosis of benign rolandic epilepsy is based on the pattern of seizures as well as testing which includes EEG, MRI and neurological exams. If symptoms remain mild, no treatment is needed as the seizures are often harmless and do not occur frequently. Symptoms that may suggest treatment would include learning difficulties, behavioral problems, daytime seizures or seizures that are frequent or become more severe. Anti-seizure medications are available in some cases. Please see a specialist if your child is having these symptoms to discuss the most current treatment options.