John Libbey Eurotext

Epileptic Disorders

The Educational Journal of the

Introduction Volume 2, supplement 4, Supplément 1, Décembre 2000

Authors
Kiel, Germany Uppsala, Sweden
  • Page(s) : 1-2
  • Published in: 2001

Rolandic epilepsy is the most common partial epilepsy of childhood. It seems to be a clearly defined entity and is classified as one of the idiopathic partial epilepsies. Because of its definite, self limited course (the ILAE classification commission termed it synonymously benign childhood epilepsy with centrotemporal spikes, BECTS) rolandic epilepsy seems not to deserve special interest and many epileptologists, do not appreciate its clinical and scientific challenges. Probably, it is one of the most overlooked epilepsies due to the multiplicity of its clinical presentation (partial and generalised, simple and complex seizures, seizures with uncertain vigilance). Strictly speaking, any neurological finding (e.g. intellectual problems, pareses, MRI-findings in patients with rolandic epilepsy, etc.) prevents its inclusion among the idiopathic epilepsies. Its aetiopathogenesis is multifactorial since genetic influences are present but no Mendelian pattern can be defined. What are the reasons for its self limited course, for the slight male preponderance, and the relation to sleep? What are the borderlines of its semiology? Are astatic seizures (e.g. due to negative myoclonus) and absences reasons to reject the diagnosis? Why do certain genetic syndromes such as Rett's syndrome and fragile X-syndrome express rolandic discharges, the most important diagnostic laboratory proof of rolandic epilepsy? What are the pathological and pathophysiological causes of the migrating and side changing expressions of hypersynchronous activities in rolandic epilepsy? These questions arise immediately during the reading of the proposal of ILAE classification on rolandic epilepsy. Many more questions arise when looking at the details. Some of them are presented and discussed in this volume.