“Rolandic Foci” in Epilepsies and Neuropsychiatric Disorders

“Rolandic Foci (RF)” are a distinct EEG pattern with monomorphic spikes localized in the centro-temporal area. The spikes tend to appear in cluster and to increase in frequency during sleep. Divergent and shifting localizations are common. RF are the EEG trait of Rolandic-epilepsy (benign epilepsy of childhood with centro-temporal spikes—BECT) and predominantly appear between ages 2 to 10 years and disappear during adolescence. Spikes, including RF are also found in 2 to 3% of healthy children. They are not associated with epilepsy and disappear during late childhood. RF also occur in children with genetically caused neurologic and epileptic syndromes like fragile X syndrome, benign familial neonatal seizures (KCNQ2 und KCNQ3), KCNQ2 encephalopathy, GRIN2A mutations and others. They are even found in children with brain lesions or after severe head trauma. Also in these children RF seem to disappear during brain maturation. Autism spectrum disorders (ASD) are often associated with epilepsy and epileptiform EEG abnormalities. Spikes are mentioned in 10 to 80% of the EEG registrations, whereby the higher percentages are found in long-term EEG monitoring or sleep registrations. Centro-temporal spikes are more frequently found in ASD patients without epilepsy, and frontal spikes in those with epilepsy.

Conclusion: RF not only occur in Rolandic epilepsy, but also in healthy children and children with genetically caused epilepsies, organic brain lesions and neuropsychiatric disorders. Most of the affected children did not suffer from epilepsy. The impression is that RF and the respective seizures (if associated) disappear during late childhood, similar to those in Rolandic epilepsy.