title: Incidental rolandic spikes: long-term outcomes and impact of treatment.
abstract: We describe a group of 26 children with no prior history of seizures consistent with benign rolandic epilepsy who had rolandic spikes found coincidentally on EEG. A retrospective chart review as well as phone and email follow-ups with families were completed to assess long-term outcomes. A subset of this group (n=7) with reported comorbid language or learning difficulties was then given an empiric trial of levetiracetam. Seven (27%) children eventually developed seizures, with a median of 14months after the abnormal EEG. Of the 7 children ever treated with levetiracetam, 5 exhibited beneficial effects on learning, speech, or behavior. Side effects reported were mild and included irritability and headache. Incidental rolandic spikes may represent a discrete neurologic condition, with approximately one-quarter of the patients later developing epilepsy. Some of these children may experience improved intellectual functioning with levetiracetam.
authors.affiliation: Division of Child Neurology, Department of Pediatrics, Johns Hopkins University School of Medicine, USA; Division of Child Neurology, Department of Neurology, Johns Hopkins University School of Medicine, USA.
authors.forename: Melanie A
authors.initials: MA
authors.lastname: McNally
authors.affiliation: Division of Child Neurology, Department of Pediatrics, Johns Hopkins University School of Medicine, USA; Division of Child Neurology, Department of Neurology, Johns Hopkins University School of Medicine, USA. Electronic address: ekossoff@jhmi.edu.
authors.forename: Eric H
authors.initials: EH
authors.lastname: Kossoff
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D019305:Epilepsy, Rolandic / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000139:chemically induced / Q000523:psychology; D006801:Humans; D007508:Irritable Mood / Q000187:drug effects; D007805:Language Development Disorders / Q000150:complications / Q000523:psychology; D007859:Learning Disabilities / Q000150:complications / Q000523:psychology; D000077287:Levetiracetam; D008137:Longitudinal Studies; D008297:Male; D010889:Piracetam / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D000077287:Levetiracetam; D010889:Piracetam
keywords: Cognition; EEG; Epilepsy; Levetiracetam; Rolandic