Is rolandic discharge a hallmark of benign partial epilepsy of childhood?

A longitudinal study was conducted in 89 children with partial seizures who had rolandic discharges on their interictal EEGs. The clinical characteristics and seizure prognosis were compared in children without an organic background (idiopathic) and in children with an organic background (symptomatic). Since rolandic discharges and sylvian seizures were found in the symptomatic children and their seizure outcome was favorable, it is likely that they are symptomatologically close to benign childhood epilepsy with centrotemporal spikes. Some of the symptomatic patients may have had complex partial seizures, although rolandic discharges were the principal EEG finding. Their seizure prognosis was as unfavorable as that of the patients with other symptomatic partial epilepsies. The rolandic discharges disappear in an age-related manner in idiopathic patients, but tend to persist in the symptomatic ones. The presence of rolandic discharges was not considered a hallmark of a benign outcome. Instead, the presence of sylvian seizures heralds a benign outcome of partial epilepsies regardless of whether they are idiopathic or symptomatic.