Rolandic epilepsy – may not treat — RACP Paediatrics MCQ

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EasyNeurologyRolandic epilepsy – may not treatRACP Paediatrics

An 8-year-old with benign rolandic epilepsy has infrequent nocturnal focal seizures (2 in the past year). He is otherwise well with normal development. The parents ask about treatment. What is the most appropriate approach?

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Correct answer: E — Carbamazepine

Benign rolandic epilepsy (self-limited epilepsy with centrotemporal spikes) has an excellent prognosis with spontaneous remission by puberty. Treatment is often unnecessary for infrequent seizures. If treatment is needed, carbamazepine or levetiracetam are first-line. Sodium valproate is an alternative. The decision to treat should weigh seizure frequency/impact against medication side effects.

Reference: Australian Therapeutic Guidelines – 2024; RACP Paediatric Curriculum – Neurology