Cortical auditory dysfunction in benign rolandic epilepsy.
OBJECTIVE
To evaluate cortical auditory function, including speech recognition, in children with benign rolandic epilepsy (BRE).


METHODS
Fourteen children, seven patients with BRE and seven matched controls, underwent audiometric and behavioral testing, simultaneous EEG recordings, and auditory-evoked potential recordings with speech and tones. Speech recognition was tested under multiple listening conditions.


RESULTS
All participants demonstrated normal speech recognition abilities in quiet, as well as normal peripheral and subcortical auditory function. BRE patients performed significantly worse than controls when speech recognition was tested under adverse listening conditions, including background noise. Five BRE patients who were impaired on two or more tests had centrotemporal spiking on awake EEG. There were no significant group differences in the latency or amplitude of early N100 cortical responses to speech or tones. Conversely, the mismatch negativity, a preattentive index of cortical processing that is elicited passively, was absent or prolonged for speech, but not tones, in BRE patients as compared to controls.


CONCLUSIONS
Children with BRE demonstrated specific speech recognition impairments. Our evoked potential findings indicate that these behavioral impairments reflect dysfunction of nonprimary auditory cortex and cannot be attributed solely to attention difficulties. A possible association between auditory impairments and centrotemporal spiking (>1/min) on awake EEG was identified. The pattern of speech recognition impairments observed is a known risk factor for academic difficulties in school-age children. Our results underscore the importance of comprehensive auditory testing, using behavioral and electrophysiological measures, in children with BRE.
Boatman
Dana F
DF
Department of Neurology, John Hopkins Hospital, Baltimore 21287, USA. dboatma@jhmi.edu
Trescher
William H
WH
Smith
Cynthia
C
Ewen
Joshua
J
Los
Jenna
J
Wied
Heather M
HM
Gordon
Barry
B
Kossoff
Eric H
EH
Gao
Qian
Q
Vining
Eileen P
EP
D001288:Attention / Q000502:physiology; D001303:Auditory Cortex / Q000503:physiopathology*; D001308:Auditory Perceptual Disorders / Q000175:diagnosis / Q000503:physiopathology*; D001933:Brain Stem / Q000503:physiopathology; D002648:Child; D003265:Contingent Negative Variation / Q000502:physiology; D003937:Diagnosis, Differential; D004292:Dominance, Cerebral / Q000502:physiology; D004569:Electroencephalography; D019305:Epilepsy, Rolandic / Q000175:diagnosis / Q000503:physiopathology*; D005072:Evoked Potentials, Auditory / Q000502:physiology; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D006320:Hearing Tests; D006801:Humans; D008297:Male; D010470:Perceptual Masking / Q000502:physiology; D011930:Reaction Time / Q000502:physiology; D012815:Signal Processing, Computer-Assisted; D013067:Speech Perception / Q000502:physiology*; D013069:Speech Reception Threshold Test; D013702:Temporal Lobe / Q000503:physiopathology*