Atypical rolandic epilepsy spectrum and related conditions

In the last decade, a sufficient amount of data has accumulated that testifies to the ambiguity of the assertion about the «benignity» of benign childhood epilepsy with centro-temporal commissures («Rolandic»). More and more researchers are providing evidence of cognitive impairment associated with age-dependent epilepsy. A literature review is given on this problem, the main trends and main criteria the diagnosis of typical and atypical age-dependent epilepsy with centro-temporal commissures on the electroencephalogram are considered. It has been established that the main criteria for the atypical nature of age-dependent epilepsy include such signs as the intermittent focus of slow waves, multiple asynchronous peak waves, long peak wave clusters, generalized 3 Hz «absance-like» runs, the relationship of interictal paroxysms with negative or positive myoclonus, and abundance interictal finds during wakefulness and sleep. A continuum of conditions associated with the condition under consideration is highlighted, which includes a number of conditions from relatively favorable to severe and disabling. We have singled out the term «atypical rolandic epilepsy», which has already taken shape in the world literature and includes such signs of atypicality as: early debut of seizures (up to 4 years), the presence of daytime seizures, duration of seizures (more than 30 minutes), with a tendency to form status, changes in neuroimaging studies (both morphological - computed and magnetic resonance imaging - and functional - positron emission tomography), impaired cognitive and / or behavioral sphere (including Indra attention deficit hyperactivity disorder), disorders of motor development as well as the mental and speech development, atypical manifestations in the electroencephalogram (unusual localization rolandic spikes, their generalization, the presence of «3Hz absansopodobnyh runs»).