Speech and Oromotor Deficits of Epileptic Origin in Benign Partial Epilepsy of Childhood with Rolandic Spikes (BPERS)

Abstract

The authors report three children who suffered temporary oromotor or speech disturbances as focal epileptic manifestations within the frame of benign partial epilepsy of childhood with rolandic spikes and review similar cases described in the literature. The deficit can occur as an initial symptom of the disorder without visible epileptic seizures and interferes in a variable way with simple voluntary oromotor functions or complex movements including speech production, depending on the exact location and spread of the discharging epileptic focus around the perisylvian region. The most severe deficit produces the anterior operculum syndrome. More subtle non-linguistic deficits such as intermittent drooling, oromotor apraxia or dysfluency, as well as linguistic ones involving phonologic production, can occur. The rapidity of onset, progression and recovery of the deficit is very variable as well as its duration and presumably reflects the degree of epileptic activity. In some cases, rapid improvement with antiepileptic medication occurs and coincidence between the paroxysmal EEG activity (which is usually bilateral) and the functional deficit is seen. The clinical and EEG profile of the seizures disorder and the dynamic of the deficit in these cases bear a strong resemblance to what is seen in the acquired epilepsy-aphasia syndrome (Landau and Kleffner). The variations in clinical symptoms appear more related to the main site, local extension and bilaterality of the epileptic foci rather than a basic difference in physiopathology.

Benign rolandic epilepsy: clinical and electroencephalographic correlates

“…The association of rolandic spikes and certain stages of Rett syndrome has been previously described 22 , and was recently confirmed 23 . We observed three cases with speech disorders, two in the group without convulsions and one in the group with BRE; it is possible that these cases present similarities with those described by Roulet et al 30 , and also by Deonna et al 31 .…”

Acquired childhood dysarthria: Review of its clinical presentation

“…The mode of onset, relapses, and evolution show various patterns [39]. Outcome is favorable once the epilepsy is adequately treated.…”

The Influence of Sulthiame on EEG in Children with Benign Childhood Epilepsy with Centrotemporal Spikes (BECTS)

“…In contrast to CZP, no EEG normalization could be found in the 10 patients treated with CBZ in that study. In addition, CBZ may have the disadvantage of worsening EEG characteristics and precipitating of epilepsy with continuous spikes and waves during slow sleep (CSWS) in a considerable number of patients (3,4,(9)(10)(11)(12)(13), although this influence is controversial (14). Early observations showed positive effects of STM treatment on the interictal EEG in BECTS (2,11,15).…”