Is rolandic epilepsy really benign? Epilepsia rolândica é realmente benigna?

Epilepsies can be considered as benign as long as they do not compromise the longterm quality of life of the person. Benign epilepsy with centrotemporal spikes (BECTS) or rolandic epilepsy (RE) is usually considered as a good example of this situation. RE has a number of clinical and electroencephalography (EEG) features that indicate a favourable outcome. Classically, RE is described as partial epilepsy of childhood characterized by absence of neurological deficits, motor partial seizures, peculiar EEG centrotemporal spikes and spontaneous recovery. There are also children with peculiar EEG centrotemporal spikes with no clinical seizure, called EEG traits for RE. Although RE is considered a benign syndrome and, in theory, with no neurological impairment, children with RE may have neuropsychological problems more often than the general population 1 . Even if neuropsychological involvements are considered as mild, the impact of RE on cognitive functions is far from being negligible 2 . Delayed speech and learning disabilities have been reported, but their incidence and the long-term impact remains undetermined. The basic mechanism of cognitive compromise, in this syndrome, also remains unclear. It is difficult to determine, whether the deficits are due to the basic brain dysfunction responsible for the epilepsy, or to other factors such as, the effects of ongoing epileptic activity on developing cognitive functions. Neuropsychological studies of children with RE show that they have normal intelligence but often have limited weaknesses in various domains such as language, visuospatial abilities or isolated attendant problems.