Benign rolandic epilepsy (Benign childhood epilepsy with centrotemporal spikes - BECTS)


Benign Rolandic epilepsy (benign epilepsy of childhood with centrotemporal spikes or BECTS) is an idiopathic age-related epileptic syndrome diagnosed by a combination of clinical picture and EEG findings. It is one of the benign epileptic syndromes that occur in normal children, and are probably genetic in nature. Features of BECTS include: [Kaddurah: 2007]
  • possibly the most common epilepsy syndrome in childhood;
  • age range is 2-13 years of age, although most commonly between age 4 and 11; and
  • Seizures that occur as part of BECTS:
    • brief simple partial seizures with associated somatosensory symptoms that often spread, sometimes in the typical "Jacksonian march" or generalized into tonic-clinic seizures;
    • occur mostly at night (50-81%), although in some may occur during sleep and awake states (5-40%) or only while awake (0-32%);
    • occur infrequently;
    • show unilateral somatosensory involvement, often of the tongue;
    • interrupt speech;
    • may lead to pooling of saliva and gurgling noises (ask specifically about these symptoms); and
    • do not cause confusion or amnesia.
  • EEG typically shows high-voltage centrotemporal spikes that may be followed by a slow wave; EEG changes may be present without clinical seizures in BECTS families;
  • May be more common in boys than girls.
  • Remission is expected and there are no neurologic precursors or sequelae;

Clinical Assessment

A typical clinical picture and EEG in a child with normal development and neurological exam does not warrant further investigation. Anything atypical should prompt further investigation.


If seizures are infrequent and family is comfortable, the patient does not need antiepileptic drug treatment. Although BECTS may be associated with status epilepticus, treatment does not necessarily alter this possibility. Carbamazepine and others, possibly only once a day (before bedtime), may be sufficient to prevent seizures. Most patients stop having seizures by adolescence.


Helpful Articles

PubMed search for articles on Benign Epilepsy with Centro Temporal Spikes (BECTS) in children for the last 3 years.

Kramer U, Zelnik N, Lerman-Sagie T, Shahar E.
Benign childhood epilepsy with centrotemporal spikes: clinical characteristics and identification of patients at risk for multiple seizures.
J Child Neurol. 2002;17(1):17-9. PubMed abstract


Author: Denise Morita, MD - 6/2011
Compiled and edited by: Lynne M Kerr, MD, PhD - 6/2011

Page Bibliography

Kaddurah, AK and Mooriani, B.
Benign Childhood Epilepsy.
Emedicine from WebMD; (2007) Accessed on 1/16/2007.
A helpful article regarding various benign childhood epilepsy syndromes