Benign rolandic epilepsy (BRE) also known as benign epilepsy with centro-temporal spikes (BECTS) is a focal epilepsy of childhood characterized by motor focal seizures and particular EEG abnormalities in the absence of neurological deficits [1]. BRE is the most common form of idiopathic epilepsy in children [2]. In spite of the concept that the qualification “benign” should be avoided in the milder epilepsy syndromes such as BRE, in this study we have kept this term. [3]. In the recent ILAE Classification proposal the term “idiopathic” has been replaced by “genetic” [۳]; however, as the genetic marker in patients with BRE is not well known, it could be considered as probably genetic. Here, we have also maintained the terms “idiopathic localization-related epilepsy” and “idiopathic generalized epilepsy (IGE)”. In BRE the seizures are usually infrequent, brief, and partial, paradoxically showing abundant interictal EEG abnormalities, and remit spontaneously before the end of adolescence [4]. The seizures are somatosensory and motor focal, mainly affecting the face and oropharynx, with speech arrest and hypersalivation and in some cases involving the upper limbs [5]. The typical EEG shows high-voltage spikes or spikes and waves in the centrotemporal region that may shift from side to side with a normal background. In BRE patients, generalized spike-wave discharges are rather common and brief. Generalized 3–۵-Hz slow-wave bursts intermixed with small spikes, with or without clinical seizures, were reported to occur in 4% of the cases [6,7]. BRE is easily diagnosed based on EEG features. Generalized spike discharges, also observed in childhood absence epilepsy (CAE) or IGE, were found to be appearing with or without seizures during follow-up periods. Considering the benign, age-related, and age-limited features of idiopathic localization-related epilepsies and IGEs, this finding suggests a neurobiological continuum between the two epilepsies [8]. The aim of this study was to describe BRE patients in whom EEG findings were generalized spikes and waves as the only manifestation at onset.