Abstracts

The objective of the study was to compare the clinical course and outcome of children with typical and atypical features of Benign Epilepsy of Childhood with Rolandic Spikes (BECRS). A retrospective case series design was used in the setting of a tertiary care pediatric hospital. One hundred and twenty six children with BECRS were selected for the study. The patients were divided into two groups based on their clinical presentation. Group A consisted of children with typical features of BECRS. Group B consisted of those with atypical features. Atypical features included age of onset, abnormal neurological exam, developmental delay, and presence of other types of seizures. Patients[apos] charts were reviewed for demographic data, family history, comorbid conditions, atypical clinical features, anticonvulsant drugs, and outcome data. Atypical features were seen in 47% of patients. Comorbid disorders such as Attention Deficit Hyperactivity Disorder and behavioral problems, although seen in both groups, were slightly more frequent in the atypical group. Sixty-seven percent of children had a family history of migraine and 54% were migraine sufferers. Overall, there was no difference between time to become seizure free between the groups: 62% of the typical group was controlled on medication by two years while 71% of the atypical group was seizure free. Thirty-five percent of the typical BECRS group were incompletely controlled on medication, while 65% of the atypical group required the addition of a second anti-epileptic drug. Resolution of the epilepsy occurred at about the same age in both groups with similar long term outcomes. Atypical features in BECRS are common. Comorbid disorders are seen in both groups. Personal or family history of migraine appears to be associated with the disorder. Overall, the long term outcome is similar in both groups, although the atypical patients may be initially more difficult-to-control. Resolution of the epilepsy and a good long term outcome was not affected by the presence of atypical clinical features.