Abstracts

Rationale: Benign epilepsy of childhood with centrotemporal spikes (BECCT) has anteriorly oriented Rolandic discharges (A-RDs). However, clinical profiles of Rolandic epilepsy with posteriorly oriented RDs (P-RDs) remains unknown. Methods: We studied seven patients with Rolandic seizures of pediatric onset in whom magnetoencephalography (MEG) indicated unusual P-RDs. The ethics committee of Kohnan Hospital approved the study protocol. Results: In addition to typical Rolandic seizures, all of the patients had atypical seizures, such as falling, head dropping, absence, auditory hallucinations, asymmetrical postural symptom, and/or automatism. Of the seven cases, two were diagnosed as atypical benign partial epilepsy of childhood (ABPE), while the diagnosis in the remaining five cases remains to be determined. While the seizures in the two cases with ABPE were resolved with medication, the other five had medically intractable seizures. Conclusions: RDs with a posterior orientation may exclude the diagnosis of BECCT and MEG is useful tool for detecting such patients.