Epilepsy Information

(Abst. 2.295)

Cognitive deficits in children with benign rolandic epilepsy

Authors: Robert Trobliger, M. Fiorito-Grafman, K. Perrine and M. Lancman

Benign rolandic epilepsy is a common childhood seizure disorder, typically involving partial motor seizures, sensory seizures, and, less frequently, tonic-clonic seizures. The condition often resolves by adolescence. Initial research with this population demonstrated regular motor but not cognitive deficits (Heijbel & Bohman, 1975, Epilepsia, 16, 679 - 687). However, more recent studies have shown various cognitive and behavioral deficits, particularly in the areas of attention and executive functions (Giorani et al., 2006, Epilepsy Res, 70, 89 - 94; Gunduz, Demirbilek, & Korkmaz, 1999, Seizure, 8, 246 - 249). The aim of this study is to examine the cognitive profiles of children with benign rolandic epilepsy through neuropsychological testing.


A total of 13 children with benign rolandic epilepsy, confirmed through EEG testing were evaluated. There were 6 males and 7 females in the sample. The mean age of the sample was 9.9 years (range 6 - 15 years) and the mean education level was grade 4.4 (range K - 8). One of the children had a history of special education. All underwent neuropsychological testing. The neuropsychological evaluation included testing of memory abilities (California Verbal Learning Test - Children’s Edition, Wide Range Assessment of Memory and Learning, and Rey Complex Figure Test) and attention/executive functions (various Wechsler Intelligence Scale for Children - Fourth Edition subtests; Connors’ Continuous Performance Test - II; various NEPSY-II subtests) as well as parental endorsements of behaviors involving inattention, hyperactivity, impulsivity, and executive functions (Conners’ Parent Rating Scale - Revised: Long Version; Connors - Third Edition; Behavior Rating Inventory of Executive Function.

Specific neuropsychological deficits were noted for 11 of the 13 children on tasks involving frontal lobe functions, specifically auditory working memory, visual attention, and sustained attention. Furthermore, elevations in the mild to extreme range were noted on completed parental measures of perceived levels of inattentiveness for 8 of the children.

Analysis demonstrated consistent deficits in the area of attention. Clinical range difficulties involving inattention as observed by parents was also a consistent finding. In contrast to previous research suggesting consistent difficulties related to motor skills, deficits were found for only 3 children in the area of motor functioning and only 4 children in the area of visuomotor integration. These findings suggest that this syndrome is not in fact as “benign” as previously considered. Neuropsychological testing should therefore be systemically considered with this population to determine possible areas of cognitive weakness. Evaluation results may also be useful in generating appropriate treatment recommendations, including medication, cognitive remediation, academic accommodations, and educational services.