Researchers at the Epilepsy Center and Department of Neurology, Maastricht University Medical Center, The Netherlands investigated a correlation between language, learning and locomotor impairments in a cohort of 48 children (6.5-13 years of age; 26 boys and 22 girls) with rolandic epilepsy referred to the Epilepsy Center between 2001 and 2009. EEG recordings and neuropsychological assessments were obtained within the same week. Parents completed a questionnaire on developmental milestones, attention, language, visuospatial skills, memory, reading, writing, and math. A learning efficacy quotient was calculated by dividing the educational level by months of education x 100, and <100 score was an educational delay. Mean age at testing was 9 years 7 months; 39 were right-handed.

Parents reported significant delays in reading skills (words, 6 months; sentences, 8.6 months) in 23 (47.9%) children, delays in language expression in 18 (37.5%), problems in mathematics in 14 (29.2%), and motor development delay in 11 (22.9%), compared with the healthy population. There was a significant correlation between problems in motor development and delays in reading skills (words, p=0.006; sentences, p=0.03). Neuropsychological tests of reading performance indicated that 45% of children with rolandic epilepsy had a word reading quotient of <70 and 55% had a sentence reading quotient <70. [1]

COMMENT. A high prevalence of language impairment in children with rolandic epilepsy is confirmed. Reading of sentences (semantic language skills) is more impaired than reading of words. Language delays are correlated with delays in motor milestones, and with the localization of epileptiform activity originating from the rolandic strip.

Reading performance in children with rolandic epilepsy correlates with epileptiform activity in sleep but not while awake [2]. Reading sentences showed a negative correlation with the amount of nocturnal epileptiform activity in 26 children with rolandic epilepsy and a trend in this correlation for reading words. Nocturnal epileptiform activity also correlated negatively with Verbal IQ. No correlation was found between reading performance or Verbal IQ and the amount of diurnal epileptiform activity.