Incidental rolandic spikes: long-term outcomes and impact of treatment

Epilepsy Behav. 2015 Feb:43:135-8. doi: 10.1016/j.yebeh.2014.12.007. Epub 2015 Jan 24.

Abstract

We describe a group of 26 children with no prior history of seizures consistent with benign rolandic epilepsy who had rolandic spikes found coincidentally on EEG. A retrospective chart review as well as phone and email follow-ups with families were completed to assess long-term outcomes. A subset of this group (n=7) with reported comorbid language or learning difficulties was then given an empiric trial of levetiracetam. Seven (27%) children eventually developed seizures, with a median of 14months after the abnormal EEG. Of the 7 children ever treated with levetiracetam, 5 exhibited beneficial effects on learning, speech, or behavior. Side effects reported were mild and included irritability and headache. Incidental rolandic spikes may represent a discrete neurologic condition, with approximately one-quarter of the patients later developing epilepsy. Some of these children may experience improved intellectual functioning with levetiracetam.

Keywords: Cognition; EEG; Epilepsy; Levetiracetam; Rolandic.

MeSH terms

  • Anticonvulsants / adverse effects
  • Anticonvulsants / therapeutic use*
  • Child
  • Child, Preschool
  • Electroencephalography
  • Epilepsy, Rolandic / complications
  • Epilepsy, Rolandic / drug therapy*
  • Epilepsy, Rolandic / psychology
  • Female
  • Follow-Up Studies
  • Headache / chemically induced
  • Headache / psychology
  • Humans
  • Irritable Mood / drug effects
  • Language Development Disorders / complications
  • Language Development Disorders / psychology
  • Learning Disabilities / complications
  • Learning Disabilities / psychology
  • Levetiracetam
  • Longitudinal Studies
  • Male
  • Piracetam / adverse effects
  • Piracetam / analogs & derivatives*
  • Piracetam / therapeutic use
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Anticonvulsants
  • Levetiracetam
  • Piracetam