Abstracts

Rolandic epilepsy (RE) constitutes about 17% of all childhood epilepsies. A right diagnosis based on both characteristic seizure manifestations and typical EEG in mentally normal children is compulsory. Throughout the last years, RE has been reported in children with cerebral lesions of different etiologies and clinical presentations. Also cognitive impairment has been described in RE.
MRI was performed in 18 children, MRS in 13 children, neuropsychological evaluation in 32 children and oromotor assessment in 24 children with genuine RE (RE [apos]pure[apos]).
Hippocampal asymmetries and/or high signal intensities on T2-weighted images beneath the cortex-white matter junction in the frontal and temporal lobes were seen in 56%. The tNAA/tCr asymmetry index of the hippocampal region was significantly higher in children with RE compared with controls. Neuropsychologically, a deficit in executive and auditory-verbal memory function was revealed in children with RE compared with controls. Oromotor assessment showed significantly poorer results in articulation and tongue motor function compared with controls. In addition, the dichotic listening test was significantly poorer in children with RE.
Besides genuine RE or RE [apos]pure[apos], enteties as RE [apos]plus[apos], RE-related disorders, and [apos]encephalopathies[apos] (structural lesions) with signs and symptoms as in RE, confirm the spectrum of RE. The background to our findings in children with RE [apos]pure[apos] may depend on maturational factors. The involvement of hippocampus may explain at least some, mainly transitory, cognitive deficits. Hippocampal imbalance may also explain an effect on cortical structures as manifested in transitory electrographic findings and transitory seizure manifestations. Some children with RE may be in need of additional support in school.