Rolandic epilepsy has little effect on adult life 30 years later

OBJECTIVE: To establish the adult social outcome for childhood-onset rolandic epilepsy. METHODS: Patients with medication-treated rolandic epilepsy were identified from the Nova Scotia prospective population-based cohort of childhood-onset epilepsy. Epilepsy onset was in 1977-1985 and follow-up was in 2010-2013 with chart review plus structured telephone interview for those older than 21 years. RESULTS: Forty-two children developed rolandic epilepsy (6% of 692 incident epilepsy cases in the cohort). Thirty-two (76%) were contacted when they were older than 21 years. Epilepsy onset averaged 7.7 ± 2.3 years, follow-up 29.5 ± 2.8 years, and final age 37 ± 3.4 years. All had epilepsy remission and were off antiepileptic drug treatment for 21.4 ± 6.6 years. There were 2 minor injuries from seizures and only 1 death (from a snowmobile accident). Overall, 41% had ≥ 1 of 7 adverse social outcomes, 6 had 1, 4 had 2, and 3 had ≥ 3. These were failure to complete high school (n = 7), pregnancy outside of a stable relationship (<6 months) (n = 7), depression or other psychiatric diagnosis (n = 3), unemployment (n = 1), living alone (n = 5), never in a romantic relationship >3 months (n = 1), and poverty (n = 2). Those who did not complete high school were more likely to have parents with low academic achievement and/or low income (p < 0.02). By comparison, rates of ≥ 1 adverse social outcomes for other epilepsies with normal intelligence from this cohort varied from 62% to 76%. CONCLUSIONS: The adult social outcome for children with rolandic epilepsy is remarkably better than for those with other major epilepsies and normal intelligence.