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The atypical developments of rolandic epilepsy are predictable complications

G. Pesántez-Ríos, A. Martínez-Bermejo, J. Arcas, M. Merino-Andréu, A. Ugalde-Canitrot [REV NEUROL 2015;61:106-113] PMID: 26178515 DOI: https://doi.org/10.33588/rn.6103.2015207

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Volumen 61 | Number 03 | Nº of views of the article 11.372 | Nº of PDF downloads 951 | Article publication date 01/08/2015

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ABSTRACT

INTRODUCTION The development of atypical features in rolandic epilepsy is part of a clinical spectrum of phenotypes that are variable, idiopathic and age-dependent, as well as having a genetically determined predisposition.

AIM To study the electroclinical characteristics suggesting an atypical development in rolandic epilepsy.

PATIENTS AND METHODS A retrospective search was performed in 133 children diagnosed with atypical benign focal epilepsy (ABFE), Landau-Kleffner syndrome and continuous spike-wave during sleep (CSWS). Nine patients were selected, all of whom presented atypical clinical features and an electroencephalogram (EEG) pattern of electrical status epilepticus during sleep (ESES) in the course of their rolandic epilepsy.

RESULTS The average age at onset of rolandic epilepsy was 5 years. Patients showed a deterioration of both their clinical features and their EEG recording one and a half years later, on average. ABFE was observed in three of them and CSWS in six. No cases of Landau-Kleffner syndrome were found. The EEG in wakefulness showed the focus to be in the left centrotemporal region in six patients and in three of them it was on the right-hand side. All the patients presented ESES in the EEG during sleep. An atypical pattern was observed in the regional ESES in three of the patients. Moreover, cognitive and behavioural disorders were detected due to deficits in specific learning areas, such as language, memory, attention and restlessness.

CONCLUSIONS The early onset of rolandic epilepsy, the appearance of new seizures with an increased frequency and the frontocentrotemporal focus in the EEG, which increases in frequency, both in wakefulness and in sleep, are all electroclinical characteristics of an atypical development. KeywordsAtypical rolandic epilepsy Electrical status epilepticus during sleep Neuropsychological disorders in epilepsy Rolandic epilepsy CategoriesEpilepsias y síndromes epilépticos Neuropsiquiatría Sueño

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Original

The atypical developments of rolandic epilepsy are predictable complications