What is it like?

This syndrome is known by two names: benign rolandic epilepsy of childhood (BREC) and benign rolandic epilepsy with centro-temporal spikes (BECTS). The name derives from the rolandic area of the brain, which is the part that controls movements. The term “benign” refers to the fact that most children outgrow these seizures during adolescence. The official modern name is “benign epilepsy with centro-temporal spikes” or BECTS. Yet, many people still just use the term benign rolandic epilepsy to refer to this syndrome.

A typical seizure in people with benign rolandic epilepsy (BREC or BECTS) involves twitching, numbness, or tingling of the child's face or tongue. These symptoms can interfere with speech and may cause drooling. These are a type of focal (previously called partial) seizure that lasts no more than 2 minutes and the child remains fully conscious.

Sometimes the child also may have tonic-clonic seizures, typically during sleep. The seizures are usually infrequent, but they may occur in clusters of a few at a time.

Who gets it?

This syndrome accounts for about 15% of all epilepsies in children.

  • The average age when these seizures begin is about 6 to 8 years old, but they may be seen in children from age 3 to 13. They are a bit more likely to affect boys.
  • Children with BECTS generally have normal intelligence, which is not affected by the seizures.
  • The syndrome is more common in children who have close relatives with epilepsy. BREC/BECTS is thought to be a genetic form of epilepsy with a possible link to chromosome 15q14.

How is BREC or BECTS diagnosed?

Doctors diagnose BREC/BECTS based on the description of the seizure. They may also gather information from tests such as:

  • EEG (electroencephalogram): Children with benign rolandic epilepsy have spikes on their EEG in the motor area and temporal lobes of the brain. These findings help confirm the diagnosis.
  • MRI (magnetic resonance imaging): This test is usually normal in children with BREC/BECTS. An MRI may not be needed if the history and EEG are consistent with the diagnosis of BREC/BECTS.

Example of an EEG in a child with BREC/BECTS

EEG example of BNE

Tell me more

Some children will have learning difficulties and behavioral problems during the period of time that they have seizures. The problems typically disappear once the seizures stop and the EEG goes back to normal.

What can trigger seizures in persons with BREC/BECTS?

Seizures with this syndrome can be triggered by sleep deprivation. Not getting enough sleep, having interrupted sleep or a poor quality of sleep can all lead to sleep deprivation.

Find information on sleep deprivation triggering seizures.
Find information on sleep and epilepsy.

How is BREC/BECTS treated?

Because the majority of children have fewer than 10 seizures, many do not take any seizure medicines for this type of epilepsy. Medication may be prescribed if a child has daytime seizures, frequent seizures, a learning disorder, or some cognitive problems.

The seizures usually can be controlled by any of the common seizure medicines. Oxcarbazepine (Trileptal or Trokendi XR), carbamazepine (Tegretol or Carbatrol), gabapentin (Neurontin), zonisamide (Zonegran), levetiracetam (Keppra), or lacosamide (Vimpat) are most often prescribed in the United States.

What's the outlook for persons with BREC/BECTS?

Most children stop having seizures 2 to 4 years after they begin. In almost every case, the seizures stop on their own by age 15.

Authored By: 
Gregory L. Holmes, MD
Robert S. Fisher, MD, PhD
Angel Hernandez, MD
Reviewed By: 
Angel Hernandez
Reviewed Date: 
Monday, February 2, 2015