(Sylvan Seizures)

Benign rolandic epilepsy is so named because the focus of repetitive spike activity in the brain is predominantly within the mid-temporal or parietal areas, near the motor or rolandic strip.

Seizures usually occur infrequently as generalized nocturnal seizures characterized by a variety of minor tonic-clonic movements, often affecting only one side of the face. A seizure begins with a sensation starting at the corner of the mouth, followed by jerking of that corner. The jerking may then spread to the rest of that side of the face, in turn causing a twisting motion.

Excessive salivation occurs, along with possible speech arrest. The child usually does not lose consciousness, except in cases of secondarily generalized seizures of this type. In rare cases, the seizure may progress to encompass the entire side of the body, becoming a generalized tonic-clonic condition.

Onset is usually after three years of age. One quarter of school-age children with epilepsy may have rolandic seizures. The condition is benign and is frequently outgrown by adolescence.

Medication is not prescribed generally. In chronic cases, carbamazepine or phenytoin may be prescribed. It is tapered off and discontinued after puberty or after a seizure-free period of three years.