Negative myoclonus can be observed in some cases, as an interruption of tonic muscular activity Oropharyngolaryngeal ictal manifestations are unilateral sensorimotor symptoms inside the mouth.

Numbness, and more commonly paraesthesias (tingling, prickling, freezing), are usually diffuse on one side or, exceptionally, may be highly localized even to one tooth.

We heard her making strange noises ‘like roaring’ and found her unresponsive, head raised from the pillow, eyes wide open, rivers of saliva coming out of her mouth, rigid.

Hypersalivation, a prominent autonomic manifestation, is often associated with hemifacial seizures, oro-pharynx-laryngeal symptoms and speech arrest.

Syncope-like epileptic seizures may occur, probably as a concurrent symptom of Panayiotopoulos syndrome: She lies there, unconscious with no movements, no convulsions, like a waxwork, no life.

This state lasts for hours to months and consists of ongoing unilateral or bilateral contractions of the mouth, tongue, or eyelids, positive or negative subtle perioral or other myoclonus, dysarthria, speech arrest, difficulties in swallowing oculofacial apraxia and hypersalivation.

An autosomal dominant inheritance with age dependency and variable penetrance has been reported, although not all studies support this theory.

[4][21][22] Linkage studies have pointed to a possible susceptibility region on chromosome 15q14, in the vicinity of the alpha-7 subunit of the acetylcholine receptor.

[citation needed] Given the benign nature of the condition and the low seizure frequency, treatment is often unnecessary.

[27] Treatment can be short and drugs can almost certainly be discontinued after two years without seizures and with normal EEG findings, perhaps even earlier.

Children with Rolandic seizures may develop usually mild and reversible linguistic, cognitive and behavioural abnormalities during the active phase of the disease.

[30][31][32][33] These may be worse in children with onset of seizures before 8 years of age, high rate of occurrence and multifocal EEG spikes.

[34][35] The development, social adaptation and occupations of adults with a previous history of Rolandic seizures were found normal.