Holtmann M, Becker K, el-Faddagh M, Schmidt M H
Klinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt.
Z Kinder Jugendpsychiatr Psychother. 2004 May;32(2):117-29. doi: 10.1024/1422-4917.32.2.117.
Rolandic epilepsy is the most frequent epileptic syndrome in childhood, electroencephalographically characterized by focal sharp waves, so called rolandic spikes (benign epileptiform discharges of childhood). These discharges occur in about 1.5 to 2.4% of children; only 10% of them suffer from epileptic seizures.
This paper reviews genetic, epidemiological, radiological, neurophysiologic, metabolic and neuropsychological findings in children with rolandic discharges.
The epileptologic course is favorable, seizures and EEG features usually resolve completely at puberty. In contrast to former assumptions, symptoms range from infrequent seizures to neuropsychological deficits and behavior problems, even in children without overt seizures. The impact of rolandic spikes on the development of affected children and their behavior is unclear. Two models try to elucidate the relation between EEG discharges and neuropsychological disorders. The first regards neuropsychological disturbances as transient cognitive impairment due to epileptiform discharges; the second model strengthens the role of a hereditary impairment of brain maturation.
The benefit of pharmacotherapy for treating neuropsychiatric symptoms in children with rolandic spikes but without overt seizures remains to be clarified.
罗兰多癫痫是儿童期最常见的癫痫综合征，脑电图特征为局灶性尖波，即所谓的罗兰多棘波（儿童良性癫痫样放电）。这些放电出现在约1.5%至2.4%的儿童中；其中只有10%会出现癫痫发作。
本文综述了有罗兰多放电的儿童的遗传学、流行病学、放射学、神经生理学、代谢和神经心理学研究结果。
癫痫病程良好，癫痫发作和脑电图特征通常在青春期完全消失。与以前的假设相反，症状范围从不频繁的癫痫发作到神经心理学缺陷和行为问题，即使在没有明显癫痫发作的儿童中也是如此。罗兰多棘波对受影响儿童的发育及其行为的影响尚不清楚。有两种模型试图阐明脑电图放电与神经心理学障碍之间的关系。第一种模型将神经心理学障碍视为由癫痫样放电引起的短暂认知损害；第二种模型强化了大脑成熟遗传损害的作用。
药物治疗对有罗兰多棘波但无明显癫痫发作的儿童神经精神症状的益处仍有待阐明。
