Rolandic Epilepsy: Retrospective Analysis of Neuropsychological and Clinical Data

Aims: Rolandic epilepsy (RE) is characterized by typical EEG discharges, absence of underlying diseases, normal cerebral morphology, and benign course with remission up to reaching puberty. The aim of this study was to assess-associated cognitive deficits and the effect of antiepileptic drugs (AED) on cognitive function in patients with RE.

Methods: Monocentric retrospective analysis of clinical and neuropsychological data from 122 patients with RE ( January 2000–2014). A total of 104 subjects received AED therapy. We assessed intellectual development, associated specific cognitive impairment and implemented therapies. Following psychological tests (PT) were used: K-ABC, HAWIK-III, HAWIK-IV, WPPSI-III, SON-R 2 ½-7, SON-R 5 ½-17, CFT 1, and CFT-20R before AED therapy, under > 6 months lasting AED therapy and after AED therapy.

Results: A total of 104 patients with AED therapy received a psychological examination. Group 1 (RE with clinically manifest seizures, n = 57): PT before AED therapy n = 33, under AED > 6months n = 47 and after AED therapy n = 7. Group 2 (RE without clinically manifest seizures, n = 47): PT before AED therapy n = 34, under AED > 6 months n = 30 and after AED therapy n = 12. Group 1 showed average intellectual performance before AED; however, intellectual performance of group 2 was low normal or below normal range. K-ABC Mental Processing Composite Score (p = 0.005), SON 2 ½-7 IQ (p = 0.026). Group 1 showed a moderate positive trend in cognitive development under > 6 months AED therapy. In group 2, an improvement in cognitive development could be found after > 6months AED therapy, particularly in K-ABC MPCS (p = 0.04).

Conclusion: RE patients without clinically manifest seizures show developmental cognitive deficits and might profit from AED therapy. Prospective studies are required.

Keywords: rolandic epilepsy, benign childhood epilepsy with centrotemporal spikes, idiopathic focal epilepsy, cognitive.