Abstracts

Rationale: Rationale: The benign focal epilepsy of childhood with centrotemporal spike (BECTS) is very frequent (25%). The seizures are focal, no frequent, and the rolandic area is involved. The cognitive functions are preserved and the neurological exam is normal, except for oral praxis. Children acquire fully developmental praxis during growth. So it is important the assessment of this cognitive function in different ages. The aim of this study is compare oral praxis of children of same age with and without rolandic epilepsy.Methods: Method: Seventy four right-handed children, with age ranging from 4 to 15 years entered the study. Patients fulfilled all clinical and electrographic BECTS criteria according to ILAE. The inclusion criteria were: two or more seizures, electroencephalogram with Rolandic discharge and normal brain magnetic resonance imaging (MRI). A control group with 239 right-handed children, with no familial/personal history of epilepsy was created for comparison. Control group was not submitted to a previous phonoaudiologic therapy, and was age, gender and school-matched. Both groups were evaluated on the same praxis tests. To evaluate oral praxis, a 44 tests protocol was created. Six of the tests were quantitative (T10; T11; T12; T15; T17 and T27) and the other tests were qualitative, as showed in Table 1. The motion list consisted on isolated or sequenced ones, approaching tongue, lips, cheeks, jaw and palate. All patients had routine waking and sleep EEG. Results received statistical treatment (ANOVA test, chi-square test and Kruskal-Wallis test). A 95% significance index was considered (p<0.05), as previously reported for biological trial. Results: Results: There was no significant difference between both groups related to age (p= 0.171). Children with BECTS showed quantitative measurements of oral praxis lower than children of the control group (p<.0001). The same feature occurred related to some qualitative measurements: children with BECTS showed a worst performance than children without epilepsy (p<.0001) in the tests: T5; T7; T16; T25; T26; T28; T33 and T43. The others tests did not show any significant difference between the two groups.Conclusions: Conclusion: There are few studies correlating oral praxis and rolandic epilepsy in childhood. Our study showed that there is some degree (quantitative or qualitative) of oral dyspraxia in those children, regardless age, when they are compared to non-epileptic children. Children with rolandic epilepsy showed a very poor result in quantitative (which have a movement sequence more difficulty than single movements) and in some qualitative tests. These tests require a more elaborated action planning, controlled by frontal lobe. We agree that the presence of those dyspraxia in epileptic group is consequence of motor planning interference, due to epileptic discharge in this area.