Somatotopic distribution of peri-rolandic spikes may predict prognosis in pediatric-onset epilepsy with sensorimotor seizures.
OBJECTIVE
Peri-rolandic spikes are typically seen in benign childhood epilepsy with centro-temporal spikes. However, some cases of epilepsy with peri-rolandic spikes manifest with medical intractability or cognitive dysfunction. The present study evaluated whether spike source localization is predictive of different prognosis of epilepsy and/or cognitive function.


METHODS
The localization of peri-rolandic spikes was compared between 6 patients whose seizure remitted under age of 15 years with no cognitive impairment (benign group) and 6 patients with either intractable epilepsy or cognitive dysfunction (non-benign group). The sources of epileptic spikes were approximated by the single equivalent current dipole (ECD) model using whole-head magnetoencephalography.


RESULTS
The spike locations in the benign group were significantly lateral (14.8±5.3 versus 5.3±3.3 mm, p<0.05), anterior (11.6±2.1 versus 3.7±4.8 mm, p<0.01), and inferior (27.7±3.6 versus 12.0±10.0 mm, p<0.01) to those in the non-benign group. Seizures tended to involve the laryngo-pharyngo-oro-facial area in the benign group and the facial-hand-foot area in the non-benign group.


CONCLUSIONS
The clear difference in spike dipole location between benign group and non-benign groups.


CONCLUSIONS
Spike localization may be useful for predicting prognosis in epilepsy with sensorimotor seizures and spikes along with central sulcus.
Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Yosuke
Y
Kakisaka
Masaki
M
Iwasaki
Kazuhiro
K
Haginoya
Akitake
A
Kanno
Shigeru
S
Tsuchiya
Nobukazu
N
Nakasato
D001921:Brain / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D019305:Epilepsy, Rolandic / Q000503:physiopathology*; D005260:Female; D006801:Humans; D015225:Magnetoencephalography; D008297:Male; D011379:Prognosis; D012640:Seizures / Q000503:physiopathology*