Childhood epilepsy with centro-temporal spikes, which doctors previously called benign rolandic epilepsy (BRE), is a form of childhood epilepsy. However, the seizures of this type of epilepsy are usually brief, and the condition does not continue into adulthood. It also does not affect the child’s development or intellect.

BRE causes focal seizures that involve half the body, usually the face. This form of epilepsy typically does not cause long-term health problems and does not affect a child’s development.

Doctors can treat the condition with medication. In most cases, the seizures spontaneously go away when a child turns 16 years of age.

Read more to learn about BRE, its symptoms, treatment, and outlook.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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BRE, which is now known as childhood epilepsy with centrotemporal spikes, is a common syndrome accounting for around 15% of childhood epilepsy.

The condition causes seizures — bursts of electrical information in the brain that lead to symptoms such as twitching or numbness. In BRE, while a child can have seizures during the day, over 90% of seizures occur at night during sleep.

Doctors call BRE “benign” because children usually outgrow the condition by adulthood. It does not affect their development and causes no long-term health issues, so the likelihood of adverse health events is low.

Typically, BRE affects children aged 1–14 years old, and it is most common in those who are 7–10 years. It is more common in males, who develop the condition at 1.5 times the rate of their female counterparts.

Children with a family history of seizure disorders may be more likely to have BRE. Approximately 25% of children with BRE have a family history of febrile seizures, which are convulsions due to fever or epilepsy.

BRE seizures typically last 2–3 minutes, and the child remains fully awake and aware during them. Symptoms usually affect one side of the body and can include symptoms such as:

  • facial twitching
  • arm and leg twitching
  • facial stiffness
  • numbness or tingling of the face and throat
  • difficulty speaking
  • drooling

Occasionally, a seizure can become generalized, which means it affects both sides of the body. This can cause additional symptoms, including:

  • shaking
  • stiffening
  • bowel or bladder incontinence
  • loss of consciousness
  • postictal state, a period of altered consciousness following a seizure

Individuals with BRE may also experience headaches, migraine, and behavioral or learning difficulties. These symptoms resolve once the seizures stop.

Most children with BRE do not have many or frequent seizures. Therefore, doctors do not always recommend treatment.

If a child has frequent seizures or seizures that happen during the day, a doctor may recommend medication. They may also advise treatment for children with learning disorders or cognitive difficulties.

People with BRE usually respond to antiseizure medications. Several options include:

  • Keppra (levetiracetam)
  • Neurontin (gabapentin)
  • Tegretol (carbamazepine)
  • Lamictal (lamotrigine)
  • Trileptal (oxcarbazepine)
  • Vimpat (lacosamide)
  • Zonegran (zonisamide)

Doctors typically recommend treatment with a single antiepileptic drug rather than multiple medications. If a child does not have seizures for 1–2 years, they may no longer need medication. A doctor can use EEG tests to help them decide if it is an appropriate time to gradually taper off the medication.

BRE is the most common form of childhood epilepsy. Other types include:

Juvenile myoclonic epilepsy

This type of epilepsy runs in families and typically begins in the teenage years. Unlike BRE, doctors consider this to be a lifelong condition. It is the most common generalized epilepsy syndrome, meaning it develops in the whole brain.

Children with juvenile myoclonic epilepsy usually experience seizures within 1–2 hours of walking in the morning or after a nap. The seizures consist of brief muscle jerks or tonic-clonic seizures.

Learn more about myoclonic seizures.

Childhood absence epilepsy

Childhood absence epilepsy usually affects children aged 4–8 years and has associations with genetics.

Absence seizures mean that the child is unresponsive and may stare blankly for up to 20 seconds. After that, the seizure will end abruptly. A child may have multiple seizures each day until they receive treatment, usually with medication.

Although people with childhood absence epilepsy do not usually have developmental delays, they may have higher rates of attention issues.

Learn more about absence seizures.

Gastaut-type childhood idiopathic occipital epilepsy

This form of epilepsy usually starts in late childhood, but it can begin from ages 1 to 19 years. Males and females are equally likely to develop the condition.

The seizures occur rapidly, frequently, and typically last for less than 3 minutes. They may involve visual hallucinations, eye pain, fluttering eyelids, headaches, and blindness.

Most children with this form of epilepsy respond to medication with carbamazepine, and seizures resolve spontaneously within 2–4 years in around 50% of children.

The outlook for a child with BRE is good. In 95% of cases, these seizures spontaneously resolve by the age of 16 years. Most children have fewer than 10 seizures, and around 1 in 5 have just one seizure in their lifetime.

If a child develops BRE at a young age, they are likely to have more seizures and prolonged periods of seizure activity. Early-onset BRE may also cause learning difficulties and speech abnormalities. However, these resolve during adolescence.

Benign rolandic epilepsy (BRE) is a benign form of childhood epilepsy that most often develops when a child is between 7 and 10 years of age. It is a benign form of epilepsy, meaning that it resolves by adolescence and causes no lasting health or developmental issues.