Abstracts

Treatment of Benign Rolandic Epilepsy (BRE), which is 15% of childhood epilepsy, is not standardized, and typically, balances benefit and medication toxicity. Data has suggested that BRE patients can suffer neuropsychiatric deficits. This study examined treatment trends, cognitive/behavioral issues, and factors predictive of neuropsychiatric problems., From 9/04 [ndash] 4/06, 55 patients met BRE clinical and electrographic criteria at our institution. Medical charts were reviewed for demographics and cognitive and behavioral issues. Statistical analysis included Chi Square and Somers[apos]d., Mean patient age was 6 years (2-13), 69% male. Neuroimaging was performed in 89% of subjects; 12 (24.5%) were abnormal. The average number of ER visits per subject for seizures was 1.2 (0-5). 16 (29%) required admissions: seizures (10), status (2), or long term monitoring (6).
EEG findings demonstrated that 25.5% had left, 18% right, and 55% bilateral discharges. 10 (18%) had additional EEG findings, including occipital and generalized discharges.
17(30%) were not treated with AEDs. Subjects averaged 3.6 seizures (1-15) prior to initiation of treatment. Of the 38 treated, the majority were on oxcarbamazepine (14) or carbamazepine (17). 15 subjects required a change in AEDs due to seizures or side effects, and 2 were treated with 2 AEDs. Seizure frequency varied from 1 to [gt]20 seizures; 41% had [gt]10 seizures.
33(60%) reported comorbidities (may be more than 1 reported): 11(20%) headaches, 15(27.3%) language difficulties, 22(40%) trouble in school, 26(43.6%) behavioral problems, 18(32.7%) attention problems, 11(20%) ADHD, and 7(12.8%) other psychiatric diagnosis.
Problems in school and bilateral discharges on EEG were statistically significant (p [lt] 0.025), but the side of discharge was not. No association existed between discharge location and language, behavior, attention, or ADHD.
Of the 55 subjects, 11 (20%) had low seizure frequency (defined as 1-2 seizures), 22 (40%) medium (3-9), and 22 (40%) high([ge]10). There was a significant association of higher seizure frequency and reported trouble in school (p[lt]0.002), ADHD (p[lt]0.015), attentional problems (p[lt]0.025), and language problems (p[lt]0.028). There was no association between seizure frequency and behavior or discharge location., BRE is less [ldquo]benign[rdquo] than historically considered. Comorbidities are present in 60% of patients, the most common are behavioral problems, trouble in school, and attention impairments. The presence of bilateral EEG discharges is a significant risk factor for trouble in school. Children with high seizure frequency have an increased risk of having trouble in school, attention problems, ADHD, and language problems. Children with BRE, whether AEDs are indicated or not, should be screened for possible cognitive, behavioral, and learning disabilities.,