Objective: To study the electroclinical characteristics and epidemiology of BECTS in children attending the Epilepsy Clinic of a tertiary care centre in North India.

Methods: Children diagnosed with BECTS (n = 32) were identified and an analysis of the clinical and electroencephalographic characteristics and treatment was done.

Result: BECTS also known as Rolandic Epilepsy occurred in children aged 3 to 10 years of age (mean: years) with a slight male predilection (M:F=3:1). All children presented with characteristic nocturnal seizures. Focal seizures were identified in 15 (47%) of the children while the rest reported GTCS seizures. A positive family history was present in 22% of the cases. EEG showed centrotemporal spikes classically. An overlap between Rolandic CSWS epilepsy was seen in 2 children and with Panayiotopoulous Syndrome in 1 child. The epilepsy in these children was pharmacoresponsive with seizures controlled on monotherapy effectively. Poor school performance was seen in 11 (35%) children. There was no learning disability noted in our group of cases.

Conclusion: BECTS although has an excellent prognosis for seizures but poor school performance due to memory difficulties despite normal intelligence and language ability validates that it may not be a “benign” epilepsy. Pediatricians should therefore lay emphasis on academic performance in comparison to that of peers, and regularly follow up for the same, as the impact of any difficulty may not be apparent early in the child's education.