Abstracts

Rationale: Benign Rolandic Epilepsy (BRE) represents approximately the 15% of childhood epilepsies. Most of BRE patients do not need treatment; however, where a treatment is required, it is necessary to select a drug with the best profile in terms of efficacy and safety. Methods: We hereby report the case of two children (males, 6 and 7 years old) who were visited at our clinic as in the recent past they had frequent short-lasting nocturnal episodes characterized by sudden reawakening, speech disability (of which they are aware of), hypersalivation. Their parents informed us that, at night, the children had other episodes beginning with guttural sounds, jerks and hemifacial spasms that sometimes spread to 4AA, associated to loss of consciousness, drooling and urinary incontinence. In post-critical phase they showed dysarthria. At the initial visit, no familiarity for epilepsy was found, the psycho-motor development and the neurological examination were normal. The interictal EEG showed high-voltage centro-temporal sharpe waves, with alternate prevalence of side, subcontinuous also at wakefulness with an increased frequency during sleep onset. BRE was diagnosed and after having evaluated the frequency and the type of seizures, often characterized by secondary generalization, we decided to start Levetiracetam in monotherapy (20mg/kg) supported also by the preliminary literature data. Results: After 2 months of therapy, nor partial nor generalized seizures were reported and no adverse events occurred. The EEG tracings evidenced a marked reduction of the epileptiform activity with only a few isolated centro-temporal spikes.Conclusions: In conclusion, Levetiracetam showed to be well tolerated and effective since the beginning of the therapy and may be considered as a valid alternative to VPA and CBZ in BRE patients requiring treatment.