Impact of Rolandic Epilepsy on Language, Cognitive, and Behavioral Functioning in Children: A Review

Abstract

The objective of this narrative review was to investigate how the clinical aspects, such as age-at-onset, epilepsy duration, centrotemporal spikes, spike location, and seizure frequency, affect various domains of language, cognition, and behavior in children with benign childhood epilepsy. Data were collected using various research databases, including Wiley Online Library, PubMed Central, Elsevier ClinicalKey, and Springer Complete Journals. Keywords such as “Benign Childhood Epilepsy” or “BECTS and language impairment” were used among other terms. Case reports, meta-analyses, and reviews were excluded. Children with benign childhood epilepsy are mainly impaired in semantic processing (receptive language), working memory, attention/inhibitory control, complex visuospatial skills, and social skills. Functional magnetic resonance imaging reveals not only structural abnormalities, but also alterations in language, sensorimotor, attentional, and social networks, suggesting long-term consequences. It so seems that the occurrence of centrotemporal spikes (with or without seizures), especially at a young age (below 6 years) and for an extended period of time, is the most meaningful contributor to the language, cognitive, and behavioral deficits in benign childhood epilepsy with centrotemporal spikes (BECTS), while the distribution of centrotemporal spikes (left, right, bilateral) seems of only little significance.

Aberrant Dynamics of Regional Coherence Measured by Resting-State fMRI in Children With Benign Epilepsy With Centrotemporal Spikes (BECTS)

“…However, this supposition needs to be further confirmed. On the other hand, it could be speculated that abnormal local synchronization in these areas results in unstable neurofluctuation and leads to a long-term impairment of the related social cognition and sensorimotor networks ( 1 , 2 , 22 , 23 ).…”

“…Benign epilepsy with centrotemporal spikes (BECTS) is an idiopathic focal epilepsy syndrome with spike-wave discharge around the Rolandic fissure, and it is the most common form of epilepsy and generally occurs between the ages of 3 and 13 ( 1 ). It is so-called “benign” because most patients have a low seizure frequency and have a spontaneous remission.…”

“…It is so-called “benign” because most patients have a low seizure frequency and have a spontaneous remission. Emerging evidence, however, suggests that the BECTS has strong associations with cognitive impairment, including language ( 2 ), attention ( 3 ), and intelligence deficits ( 4 ), which may lead to long-term effects into adulthood ( 1 , 5 ).…”

Comorbilidades neurocognitivas y psicológicas en pacientes con epilepsia de la infancia con puntas centrotemporales. Un estudio de casos y controles

“…El término ‘benigno’ ya no se recomienda, ya que no reconoce las comorbilidades presentes en algunos individuos. De hecho, estudios recientes han demostrado que los niños con EIPCT pueden tener un mayor riesgo de presentar dificultades cognitivas, conductuales o emocionales en asociación con disfunciones del lóbulo frontal, y las más prominentes son las alteraciones del habla y la disfunción ejecutiva [ 9 - 13 ]. Las causas son múltiples y pueden estar influidas por diversos factores, como el tipo de epilepsia, su etiología, la edad en los primeros síntomas, la duración de la enfermedad, la presencia de cambios estructurales corticales, la duración y la gravedad de las crisis, y los efectos adversos del tratamiento antiepiléptico [ 12 , 13 ].…”

“…De hecho, estudios recientes han demostrado que los niños con EIPCT pueden tener un mayor riesgo de presentar dificultades cognitivas, conductuales o emocionales en asociación con disfunciones del lóbulo frontal, y las más prominentes son las alteraciones del habla y la disfunción ejecutiva [ 9 - 13 ]. Las causas son múltiples y pueden estar influidas por diversos factores, como el tipo de epilepsia, su etiología, la edad en los primeros síntomas, la duración de la enfermedad, la presencia de cambios estructurales corticales, la duración y la gravedad de las crisis, y los efectos adversos del tratamiento antiepiléptico [ 12 , 13 ]. Los estudios sugieren que, antes del primer ataque epiléptico, el 50% de los niños tiene déficits cognitivos sutiles, agitación, falta de atención y síntomas depresivos, cambios que permanecen incluso después de que los ataques se controlen o remitan [ 10 , 13 ].…”