The outcome of ten untreated and 20 treated patients with benign childhood epilepsy with Rolandic spikes was studied retrospectively after recovery at the Institute of Neurology, University of Bologna, Italy. The patients had been seizure free for at least five years. The mean period of active epilepsy was 16 months for patients and 28 months for controls. All patients and controls had Rolandic and/or centrotemporal spikes on their awake EEG recording during the active epilepsy period. Seizure frequencies, seizure occurrence and duration of active epilepsy were similar in both the treated and untreated groups. No differences were found in social adjustment of the patients. The authors conclude that antiepileptic treatment may be unnecessary in most cases of benign epilepsy with Rolandic spikes. [1]

COMMENT. The authors comment that the results should be interpreted with caution because they are retrospective. If the data are confirmed by prospective studies antiepileptic drugs should be withheld unless seizures are frequently recurrent. Since the seizures are generally nocturnal and usually involve the oropharynx, parental anxiety and dangers of suffocation are factors that may dictate the need for treatment.