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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.

The cross-sectional comorbidity of child and adolescent inpatients with obsessive-compulsive disorder (OCD) was assessed.The hospital records of all inpatients treated for OCD since 1976 (31 girls, 46 boys) were compared with data from a prospective epidemiological longitudinal study (90 girls, 84 boys) in two age cohorts (15 years;or = 15 years) with regard to comorbid psychiatric diagnoses. Additionally, psychiatric Axis I diagnoses of patients with a supplementary diagnosis of compulsive symptoms (n = 45) were descriptively assessed in the client population.In the subgroup of OCD patients15 years, boys showed a higher incidence of tic disorders. OCD girlsor = 15 years showed a tendency toward more frequent comorbid affective disorders and a significant result regarding concurrent eating disorders. Eighteen of 27 female patients with supplementary compulsive symptoms requiring clinical intervention had an Axis I diagnosis of eating disorder.Due to different criteria of classification, diverging definitions of comorbidity and different age cohorts and samples, studies on comorbidity in OCD patients are difficult to compare. The frequency of comorbid psychiatric disorders may be over-estimated if the general prevalence of psychiatric disorders in terms of gender and age is not taken into account.