Is It Really Just Daydreaming? What Parents Need to Know About Rolandic Epilepsy (BECTS)

– A Common Yet Overlooked Childhood Condition with Genetic Roots

If your child often seems to drift off mid-conversation, struggles with schoolwork, or wakes up tired and grumpy despite getting to bed on time, it’s easy to think of attention issues, anxiety, or even sleep problems. But sometimes, the cause runs deeper—and is hiding in the electrical activity of the brain.

Benign Epilepsy with Centrotemporal Spikes (BECTS)—also called Rolandic Epilepsy—is a common childhood epilepsy that can explain many of these puzzling behaviours. What makes it tricky is that it often co-occurs with other conditions like ADHD, anxiety, learning disabilities, and emotional sensitivity, making it hard to spot unless you know what to look for.

💡 How Common Is Rolandic Epilepsy?

BECTS is the most common type of epilepsy in childhood, accounting for about 1 in 5 of all childhood epilepsy cases. It usually appears between the ages of 3 and 13 and typically resolves on its own by adolescence.

Importantly, epilepsy and ADHD can and often do occur together. In fact, research suggests that up to one-third of children with epilepsy may also have ADHD, and the presence of epilepsy may worsen attention, emotional regulation, and learning difficulties—especially if it goes unrecognised.

👦🏽👧🏼 Who’s Most Affected?

BECTS occurs slightly more often in boys, but girls are frequently overlooked because their symptoms may be more subtle. While boys may show more visible twitching or disruptions, girls often present with daydreaming, emotional sensitivity, anxiety, or sleep difficulties—symptoms that are easily brushed off or misattributed.

Be particularly alert if your daughter:

Seems dreamy, vague, or “tuned out”
Wakes frequently during the night or sleeps restlessly
Struggles with reading, writing, or following instructions
Is anxious, tearful, or emotionally sensitive
Becomes frustrated easily or loses confidence in her learning

These can all be signs of disrupted brain activity during sleep—even if there are no obvious seizures.

🔎 What Are the Signs of BECTS?

Children with BECTS may experience:

Brief “blank-outs” or pauses during the day
Facial twitching or tingling, especially around the mouth, usually on one side
Drooling or slurred speech, often just after waking
Night-time restlessness, unusual movements, or brief arousals from sleep
Emotional ups and downs, often tied to fatigue or poor concentration
Learning difficulties, especially with memory, language, or attention

The key thing to remember is that even subtle seizures during sleep can affect the brain’s ability to focus, process information, and regulate emotions during the day.

🧬 Genetics: Should You Look Into Your Family History?

Yes. BECTS is often genetically inherited. Parents or close relatives may recall having unusual experiences in childhood—like twitching during sleep, strange sensations, or episodes that were never explained. Some may have had undiagnosed seizures, sleepwalking, or “spells” that were never formally evaluated.

If you’re wondering whether this could apply to your child, take a moment to reflect on your own childhood or ask older family members. These stories often hold important diagnostic clues.

🧠 Why Is BECTS Sometimes Missed?

BECTS is often missed because the signs are subtle and mistaken for other challenges like attention issues, emotional sensitivity, or even behavioural difficulties. However, many children with BECTS also have:

ADHD or ADHD traits
Specific learning disabilities (especially reading and expressive writing)
Sleep-related challenges
Anxiety and emotional dysregulation
Sensory sensitivities

It’s important to understand that epilepsy doesn’t exclude other diagnoses—in fact, it can exacerbate them. When both conditions are present, treating the epilepsy often reduces the severity of attention and mood symptoms, making ADHD and anxiety easier to manage.

🧪 Getting a Diagnosis

If BECTS is suspected, your child’s doctor may recommend:

EEG scan (especially during sleep or drowsiness) to look for characteristic spikes
Detailed sleep and symptom history, including nighttime behaviours
Review of school performance, especially if there’s a history of slow progress or inconsistent learning
Family history screening to identify patterns or similar experiences

💊 Treatment: When Is It Needed?

Not all children with BECTS require medication. Many improve naturally over time. However, treatment should be considered when:

Seizures or electrical spikes are disrupting sleep and causing fatigue
Daytime attention and memory are clearly affected
There is emotional distress, anxiety, or mood swings
School progress is falling behind despite support

💊 Why Lamotrigine (Lamictin) Is Often Recommended

Lamotrigine is one of the most widely used medications for BECTS, and for good reason:

It stabilises brain activity, reducing both seizures and brainwave spikes during sleep
It has a positive effect on mood and anxiety, unlike some other anti-epileptic medications
It’s well tolerated when started slowly and increased gradually, reducing the risk of side effects

⚠️ Side Effects and Monitoring

Most children tolerate Lamictin very well, but during the initial weeks, parents should watch for:

Mild drowsiness or irritability
Occasional dizziness
Skin rash (although rare, this needs immediate medical review)

If your child is also on medication for ADHD or anxiety (e.g. methylphenidate or SSRIs), they can usually continue safely—but it’s important to monitor appetite, sleep, and mood closely and adjust doses with your healthcare provider’s guidance.

✅ What Improvements Can We Expect?

Treatment—along with good support—can lead to meaningful improvements in:

Short Term (First Few Weeks)

More settled sleep
Fewer “zoned out” moments
Calmer mood and fewer emotional outbursts

Long Term (Months Onwards)

Better concentration and learning
Reduced anxiety and emotional reactivity
More consistent school performance
Gradual return of confidence and joy

🧩 Supporting Your Child Beyond Medication

The best outcomes come from a whole-child approach, which may include:

Regular follow-up and EEGs
A consistent bedtime routine
Educational accommodations for learning needs
Emotional support, counselling, or CBT
Clear communication between parents, teachers, and clinicians

🌈 Final Thoughts: There’s Hope—and Help

BECTS is common, treatable, and often temporary. When recognised early and managed well, children can thrive—both academically and emotionally. If your child seems anxious, unfocused, or unusually tired despite sleep and support, it’s worth exploring whether something more is going on.

The earlier we understand the brain’s unique rhythm, the better we can support it.

📞 Need Support or a Second Opinion?

Dr John Flett is a paediatrician experienced in supporting children with epilepsy, ADHD, learning challenges, and emotional wellbeing.

Contact Dr Flett
📍 8 Village Road, Kloof, Durban
📞 031 1000 474
💻 Zoom consultations available for your convenience

“With knowledge, compassion, and the right treatment plan, your child can shine.”

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BECTS (Rolandic Epilepsy) is a common childhood condition that often overlaps with ADHD, anxiety, and learning difficulties. Learn how to spot the signs, explore genetic links, and get the right support for your child.