Clinical and Electroencephalographic Study of Patients with Be‐ nign Rolandic Epilepsy from the Standpoint of the Total Number of Seizures.
Authors: Kajitani Takashi , Kaueko Motonori , Kimura Takafumi , Takeda Yohko 
Published: August 2005

Eighty patients with benign rolandic epilepsy who had discontinued medication without the recurrence of seizures for 1.8–21.8 years (average, 8.7 years) were classified into 4 groups according to the total numbers of epileptic seizures. Group A consisted of 10 patients (12%) with a single seizure; group B, 28 (35%) with 2‐4 seizures; group C, 22 (28%) with 5–9 seizures; and group D, 20 (25%) with 210 seiiures during the entire course.

Boys predominated, with 60% boys and 40% girls. Males predominated in group A (70%). A positive family history of convulsive disorders (febrile convulsions, epilepsies, etc.) within third degree relatives was noted in 60%, 50%, 5096, and 60% of groups A, B, C, and D, respectively. A preceding history of febrile convulsions in infancy or early childhood was found in 30%, 1896, 15%, and 5% of groups A, B, C, and D, respectively. The main clinical seizure types were partial seizures, secondarily generalized seizures, and hemiconvulsive seizures. Partial seizures occurred in 3 cases (30%) in group A and in 19 cases (95%) in group D. The difference between these 2 groups was statistically significant (P < 0.001). As a whole, seizures occurred in 69 cases (86%) only during sleep, in 9 (11%) in both sleep and the awake state and in only 2 (3%), is one in groups A and B, respeclively, in the awake state only. The peak ages at onset in groups A, B, C, and D were 7.7, 7.0, 7.5, and 6.4 years, respectively. The period of active epilepsy (time between the first and last seizures) was <2 years in 2 (75%),7 (32%), and 4 (20%) cases in groups B, C, and D, respectively. Seizures persisted for >4 years in 6 cases in group D only. The interval between the first and second seizures was <6 months in 10 cases (36%) in group B and in 18 cases (90%) in group D (P < 0.00 I). The interval was >12 months in 12 cases (43%), I case (5%), and I case (5%) in groups B, C, and D, respectively. There were significant differences between groups B and C (P < 0.01), and groups B and D (P < 0.025). The last seizure occurred at age 3–12 years (peak age, 8.2 years) in group A, 3–12 years (peak age, 8.7 years) in group B, 7–12 years (peak age, 10.2 years) in group C, and 5–13 years (peak age, 10.1 years) in group D.

Rolandic discharges (RD) observed on EEG persisted <3 years in 6 (60%), 17 (61%), 9 (41%), and 2 (10%)cases in groups A, B, C, and D, respectively. There were significant differences between groups A and D (P < 0.025) and groups B and D (P < 0.005). One‐third of the 80 cases showed generalized spike‐wave discharges without any concomitant absence seizure in addition to the RD in the course of the illness. In 40% of group A, 25% of group B, 32% of group C, and 50% of group D, generalized spike‐wave discharges were observed.

Among these 4 groups, there were somewhat different findings regarding the preceding history of febrile convulsions, main clinical seizure types, age at onset, period of active epilepsy, interval between the first and second seizures, age at the last seizure, period of persistence of the RD on EEG, etc. Thus, we can predict that the total number of seizures during the entire course will be low when the interval between the first and second seizures is >1 year.