Rolandic Epilepsy

By | June 8, 2022

Rolandic epilepsy is a form of epilepsy that occurs in childhood patients. The disease is also known by the synonyms Rolandic epilepsy or BCECTS. Basically, the disease is the most common form of epilepsy in children.

What is rolandic epilepsy?

In principle, rolandic epilepsy is a benign epilepsy in children.

Epilepsy is partial in nature and appears in the majority of cases between the ages of three and twelve. For leaky gut syndrome definition, please visit electronicsmatter.com.

Rolandic epilepsy accounts for about one fifth of all epilepsies in children. Observations show that the disease is more common in male patients than in females.

What causes rolandic epilepsy has not yet been finally clarified. A genetic disposition is suspected.

Bystanders should try to remain calm in a seizure situation and call for help if necessary.

Causes

According to current knowledge, the causes for the development of rolandic epilepsy may lie in genetic defects. Some studies indicate that the disease arises as a result of a mutation in a specific gene. This is a mutation on the eleventh chromosome. The corresponding gene is responsible for coding a protein. This is related to the so-called histone acetyltransferase.

So far, however, the type of inheritance of the genetic defect has not been sufficiently researched. It has been shown that almost 90 percent of all people with the relevant gene do not show any symptoms of rolandic epilepsy. However, anomalies can be detected in the context of EEG examinations. In principle, there are currently only assumptions regarding the causes of rolandic epilepsy, but no reliable findings.

In the context of rolandic epilepsy, there are damaged areas in the brain that are usually focal. For this reason, the disease indicates partial epilepsy. However, a specific cause has not yet been identified. However, numerous physicians and researchers suspect that rolandic epilepsy has a genetic component.

It is partly assumed that nerve cells in the affected person change, resulting in rolandic epilepsy. Because the corresponding changes in the cells cause increased excitability. As a result, the risk of epileptic seizures increases.

Symptoms, Ailments & Signs

Various symptoms are associated with rolandic epilepsy. These sometimes vary slightly in terms of their appearance among the people affected. As a rule, patients suffer from irritation of the muscles of the face. There are frequent twitches in the facial expressions. In addition, special paresthesias are typical of the disease. Patients suffering from rolandic epilepsy usually lose the ability to speak and swallow.

Excessive saliva production. These symptoms are most prevalent when the affected person is sleeping. It is also possible that the symptoms also spread to the limbs. Basically, the frequency of epileptic seizures is relatively low. Characteristic of rolandic epilepsy are primarily so-called myoclonic or clonic epilepsy attacks.

The seizures often begin with a tingling or numb feeling around the mouth. The lips, tongue and gums are included in the symptoms. Then the corresponding areas of the face cramp on one side. When the swallowing muscles are involved, there is increased saliva production and swallowing problems.

During seizures, some patients make grunting noises or grind their teeth. Consciousness is usually not clouded. Sometimes, however, the seizures appear because people are no longer able to speak. In young children, the twitches often extend to one arm or all of the limbs on one side of the body.

Diagnosis & course of disease

In the case of characteristic symptoms of rolandic epilepsy, a doctor should be consulted, who will examine the symptoms present in more detail and make a diagnosis. For the affected patients, the pediatrician is usually the first point of contact. This will usually refer the child to a specialist.

First, the patient interview takes place, in which the patient’s guardians play an important role. As part of the anamnesis, the symptoms, living conditions and previous illnesses as well as family dispositions of the person are clarified. In a second step, various techniques of the investigation are used.

The EEG examination in particular plays an important role here. Pathological spikes can be detected in a certain area of ​​the brain, which point relatively clearly to the disease. Sometimes the EEG is performed during sleep, since some patients only show symptoms of rolandic epilepsy in this phase.

Complications

There are a number of physical and mental complications associated with rolandic epilepsy. The frequently occurring convulsions sometimes develop into severe seizures, which are associated with pain and an increased risk of accidents for those affected. Excessive saliva production can lead to aspiration and, in the most severe cases, to shortness of breath and the risk of suffocation.

The seizures have a long-term effect on the person’s mental state. Anxiety disorders that require comprehensive therapy often develop. Inferiority complexes also occur more frequently in connection with rolandic epilepsy. Finally, it can also lead to diseases of the teeth, since the repeated grinding puts an enormous strain on the periodontium.

The treatment usually proceeds without major complications. However, side effects and interactions can occur after taking anticonvulsants and other medications. Headaches, body aches and muscle pains, gastrointestinal complaints and skin irritations such as itching and redness are typical. Allergic reactions can also occur. Children and sick people are particularly susceptible to cardiovascular problems and other interactions. The active ingredient carbamazepine can lead to an increase in symptoms in some patients.

When should you go to the doctor?

Rolandic epilepsy must always be treated by a doctor. This disease cannot heal itself, so the symptoms must be treated by a doctor in any case. In the worst case, rolandic epilepsy leads to the death of the person affected or to a significantly reduced life expectancy. The earlier the symptoms are detected, the higher the probability of a positive course of the disease. A doctor should be consulted if the child suffers from involuntary twitching. Speaking or swallowing can also be very difficult for the child because an excessive amount of saliva is also produced.

If these symptoms occur, a doctor must be consulted in any case. Of course, epileptic seizures also indicate rolandic epilepsy and should be examined by a doctor. A tingling sensation in the arm or numbness in different regions of the body often also indicate rolandic epilepsy and must be examined by a doctor. First and foremost, a general practitioner can be consulted. In the event of a seizure, call an ambulance or go to a hospital.

Treatment & Therapy

Rolandic epilepsy is primarily treated with medication. The active substance sultiame is used most frequently. It is administered in coordination with the frequency of the epileptic seizures. The prognosis for rolandic epilepsy is generally very good. The seizures usually stop after puberty. For this reason, therapeutic measures are only necessary if the symptoms are particularly severe.

Various anticonvulsants such as valproic acid or clobazam are suitable for this. On the other hand, observations show that the active ingredient carbamazepine has a less beneficial effect on the symptoms in some patients. For this reason, the other drugs are the preferred means.

Prevention

So far, the exact causes of rolandic epilepsy are still largely unclear, so that no reliable information regarding prevention is possible.

Aftercare

Follow-up care for rolandic epilepsy requires that all types of seizures and their frequency have been conclusively diagnosed in the affected child or adolescent. Because generalized epilepsy seizures (grand mal seizures) require treatment and are relevant for follow-up examinations. The grand mal seizure first appears as the sufferer fainting.

The fainting is then followed by muscle twitching, foaming at the mouth, and discoloration of the face and mouth. Minor focal seizures (muscle cramps and muscle twitching) or temporary paralysis of individual parts of the body do not require follow-up care. These types of seizures usually heal benignly within two years. It is medically recommended to accompany the healing process with regular examinations in the electroencephalogram (EEG).

In the case of smaller focal seizures, however, the seizure activity is too low to be able to read it in the EEG. The task of aftercare is more incumbent on the social environment of the affected child or adolescent. The type and frequency of further seizures must be noted for check-ups and further medical treatment.

The grand mal seizure, on the other hand, requires intensive medical follow-up examinations. The aim of aftercare is to ensure that the affected child or young person is free of seizures. In principle, this can be achieved with medication (sultiame, carbamazepine or valproic acid). Regular EEG examinations and blood tests (to determine the level of medication) must be checked by a doctor to ensure that the medication is sufficient as the disease progresses.

You can do that yourself

If the child is affected by rolandic epilepsy, this can have a serious impact on the family situation. Not only those affected, but also the relatives are heavily burdened by the suffering.

In the case of a serious illness, the immediate environment must be informed about the epilepsy. The acquaintances and friends should know the most important first aid measures so that they can initiate the necessary measures in the event of an attack. However, overprotection of the child should be avoided. Especially as they get older, the affected children have to learn to deal with the condition themselves. In this way, they can develop the necessary independence to take the right measures later in adulthood.

In the event of an epileptic seizure, the child must be restrained. To avoid injuries, sharp-edged objects should be removed. The clothing must then be loosened and the child placed in a stable side position. Because those affected are usually confused after a seizure, it is important to be calm and relaxed. In addition, medical supervision is necessary. Since rolandic epilepsy repeatedly leads to seizures, protective measures must be installed in the home.

Rolandic Epilepsy