Learning disorders in children with rolandic epilepsy

Objective Classic diagnostic criteria for rolandic epilepsy (RE) include normal neuropsychological functioning. However, recent studies have suggested that attention, short-term memory, language and visual-motor abilities could be impaired in RE. Materials and methods We describe 3 children, 2 boys and 1 girl, with RE who presented a specific learning disorder. Seizure onset was between 4.5 and 7.5 years of age. In 2 patients the clinical picture was typical, with rare partial motor seizures during sleep; the girl presented at onset frequent, apparently generalized convulsive attacks, then rare cheiro-oral seizures. EEC showed frequent centro-temporal paroxysmal abnormalities prevailing on the left, subcontinuous during sleep. Results Neuropsychological assessment showed a specific learning disorder (normal IQ), with an impairment in reading, writing and arithmetic performances. In 2 patients these difficulties were already present before the start of therapy. Discussion and conclusions Careful neuropsychological evaluation is important in RE for early recognition of specific disorders. In RE there is a spectrum of severity concerning not only seizure frequency, but also neuropsychological abilities that could be influenced by the frequency and localization of EEC paroxysmal abnormalities. EEC and neuropsychological findings, as well as seizure frequency, must be addressed in the choice of therapy.