Benign Rolandic Epilepsy of Childhood (BREC)

Reviewed by: HU Medical Review Board | Last updated: November 2022

Benign rolandic epilepsy of childhood (BREC) is one of the most common types of childhood epilepsy. It is called "benign" because it usually does not cause long-term harm to the child. BREC seizures come from the rolandic area of the brain, which controls movement.1

Doctors do not know the cause of BREC. The syndrome usually goes away on its own before the child reaches adulthood. Other names for BREC include:1

  • Childhood epilepsy with centrotemporal spikes
  • Benign rolandic epilepsy with centrotemporal spikes

Who gets BREC?

Benign rolandic epilepsy typically starts between ages 6 to 8, and most kids outgrow it by the time they are teenagers. Boys are slightly more likely to have BREC than girls. BREC occurs more often in those with a family history of the syndrome. But children without a family history can also have it.1

Symptoms

BREC seizures happen in the part of the brain that controls movement, so they often cause twitching or jerking in the face, arm, or leg on one side of the body. These seizures can happen while the child is awake or asleep.1

If the child is awake, seizure symptoms may affect their tongue and face, including:1

  • Numbness
  • Tingling
  • Muscle twitching
  • Slurred speech or problems with speech
  • Drooling

When seizures happen while the child is awake, the child remains fully aware. These seizures usually last only a few minutes and do not occur often.1

Seizures that start while a child is sleeping may begin with twitching on one side of the face. This will often progress to a seizure that affects the whole body. This type of seizure is known as a generalized tonic-clonic seizure. Symptoms of this type of seizure include:1,2

  • Muscle stiffness
  • Loss of consciousness and falling to the ground
  • Rhythmic, rapid jerking of the arms and legs

If a tonic-clonic seizure lasts more than 5 minutes, it is a medical emergency. Call 911 for emergency help.2

While these seizures are terrifying to witness, most are not harmful long-term.2

Diagnosis of benign rolandic epilepsy of childhood

A doctor can diagnose BREC with a detailed health history and tests, including:1

  • Electroencephalogram (EEG), which measures and records your brain wave activity. In BREC, the EEG wave pattern shows spikes in the centrotemporal area of the brain.
  • Magnetic resonance imaging (MRI), which creates 3D images of your brain using a strong magnetic field and radio waves. MRI results are usually normal in children with BREC.

Treatment of BREC

Many children have infrequent seizures with BREC and do not need anti-seizure medicines. Those who do need these drugs can often get total relief of their symptoms with the most common medicines. The drug most commonly used to treat BREC seizures is levetiracetam (Keppra®).1

Outlook

In most cases, children with BREC have normal intelligence. And in most cases, seizures from BREC do not seem to affect a child's brain development or ability to learn. There are rare cases where BREC may lead to learning or behavior problems. But once seizures are under control, these problems go away.1

If your child has benign rolandic epilepsy, it's essential to work with a doctor to make sure your child is getting the best treatment and that their seizures are under control. With the right care, your child can lead a healthy life.1

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