title: Neuroimaging findings in children with benign focal epileptiform discharges.
abstract: OBJECTIVE
  To determine reasons for neuroimaging and neuroimaging findings in children with benign focal epileptiform discharges (BFEDs).
  
  
  METHODS
  We performed a retrospective chart review of children who had BFEDs on routine EEG and underwent brain MRI.
  
  
  RESULTS
  We identified 97 patients with BFEDs and MRI. Forty-five of these 97 patients also had seizures consistent with benign focal epilepsy of childhood with centrotemporal spikes (BECTS). Rationale for imaging in the 45 BECTS patients included historical features such as headaches (14), increase in seizure frequency (5), and new events (5). Nine MRIs were obtained prior to referral and 12 for unspecified reasons. MRI findings were not significantly different between BECTS and BFEDs patients. Fourty-one patients (42%) had abnormal findings on MRI, including T2 hyperintensities (10), hippocampal atrophy (6), malformation of cortical development (4), volume loss (5), Chiari malformation (4), and others (18).
  
  
  CONCLUSIONS
  MRIs are not routinely recommended in patients with BECTS unless atypical features are present. Atypical features which may prompt MRI include change in clinical seizure types or frequency, historical features such as headaches, abnormal neurological exam, and atypical EEG features. 42% of our selected patients had intracranial abnormalities, most of which were of unclear clinical significance. Remote infarcts and early lesions accounted for most MRI findings suggesting they may be related to BFEDs.
authors.affiliation: Epilepsy Center/Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA. sarkisr@ccf.org
authors.forename: Rani
authors.initials: R
authors.lastname: Sarkis
authors.forename: Elaine
authors.initials: E
authors.lastname: Wyllie
authors.forename: Richard C
authors.initials: RC
authors.lastname: Burgess
authors.forename: Tobias
authors.initials: T
authors.lastname: Loddenkemper
mesh_terms: D002540:Cerebral Cortex / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods; D004828:Epilepsies, Partial / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012189:Retrospective Studies