Sequential EEG characteristics may predict seizure recurrence in rolandic epilepsy

• We examined EEG characteristics related to seizure recurrence in rolandic epilepsy.
• Seizure recurrence and prolonged high-frequent EEG paroxysms were correlated.
• The abundance of awake EEG paroxysms was associated with seizure recurrence.
• Serially recorded EEG markers may predict seizure recurrence in rolandic epilepsy.

PurposeThe prognosis of rolandic epilepsy (RE) is considered favorable. Since a moderate proportion of cases presents with isolated seizures, continuous treatment should be considered only for frequent seizures. Clinical and electroencephalogram (EEG) markers to predict seizure recurrence need to be identified. The purpose of this study was to identify EEG criteria related to seizure recurrence in RE.MethodsThere were 10 children (aged 3–10 years; 6 males, 4 females) in the recurrence group and 12 (aged 4–7 years; 6 males, 6 females) in the isolated group. Occurrences of the number of spikes were scored, and the presence of rolandic discharges (RD) in the awake record was evaluated. All patients were evaluated longitudinally, clinically and by EEG, with repeated EEG recordings every 3 months. Clinical and EEG follow-up was performed for ≥4 years.ResultsSeizure recurrence and extended periods of high-frequency paroxysmal EEG abnormalities (>6 months after onset) were significantly correlated (p < 0.001). Moreover, the appearance of RD in awake recordings tended to be more prevalent in the recurrence group than in the isolated group (odds ratio 4.714).ConclusionIn addition to RD in the awake record, a combination of spike rate and extended periods of high-frequency paroxysmal EEG abnormalities may predict seizure recurrence in RE.