Electroclinical significance of rolandic spikes and dipoles in neurodevelopmentally normal children.
"Centrotemporal" (rolandic) spikes are elemental to the diagnosis of benign rolandic epilepsy (BRE) and may reveal a characteristic dipole distribution. Yet, not all children with rolandic spikes present with clinical seizures. Using additional scalp coverage according to the 10-10 electrode system, we attempted to correlate 2 specific spike features: (a) dipole fields, and (b) exact location of maximum negativity, with the presence or absence of clinical seizures in 42 neurodevelopmentally normal children with rolandic (central) spikes. Thirty-three (79%) presented with seizures. Seventeen of 21 children revealing dipoles (81%) and 16 of 21 patients without dipoles (74%) had seizures. Children with high central (C3/C4) foci were just as likely to present with seizures (10 of 15, 67%) as were those with low central (C5/C6) foci (23 of 27, 85%) (P > 0.10). The majority of our study subjects (27 of 42, 64%) revealed maximum negativity in the low central region (C5/C6), and the dipole feature was as likely to be associated with high central foci (7 of 15, 47%) as with low central foci (14 of 27, 52%). Although rolandic spikes are a reliable indicator of potential epileptogenicity, neither their exact location nor dipolar distribution help to further define the population with clinical seizures.
Department of Pediatrics (Neurology), College of Medicine, University of Florida, Gainesville 32610-0296, USA.
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Legarda
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Jayakar
D001921:Brain / Q000502:physiology* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D004827:Epilepsy / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D012016:Reference Values