A 7-year-old boy has three episodes of nocturnal twitching involving the right side of his face with drooling and inability to speak, each lasting about a minute. Neurological examination and brain MRI are normal. EEG shows bilateral independent centrotemporal sharp waves. What is the most likely diagnosis?
- A Mesial temporal lobe epilepsy
- B Benign epilepsy with centrotemporal spikes ✓
- C Juvenile myoclonic epilepsy
- D Lennox-Gastaut syndrome
Correct answer: B. Benign epilepsy with centrotemporal spikes
Explanation
Nocturnal orofacial motor seizures with speech arrest in a neurologically normal school-aged child, combined with centrotemporal spikes on EEG, define benign epilepsy with centrotemporal spikes (rolandic epilepsy). It remits spontaneously by adolescence and may need no treatment. Mesial temporal lobe epilepsy features auras, automatisms and hippocampal sclerosis on MRI, while juvenile myoclonic epilepsy shows morning myoclonic jerks with generalized polyspike discharges.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.