title: Magnetoencephalography localizing spike sources of atypical benign partial epilepsy.
abstract: BACKGROUND
  Atypical benign partial epilepsy (ABPE) is characterized by centro-temporal electroencephalography (EEG) spikes, continuous spike and waves during sleep (CSWS), and multiple seizure types including epileptic negative myoclonus (ENM), but not tonic seizures. This study evaluated the localization of magnetoencephalography (MEG) spike sources (MEGSSs) to investigate the clinical features and mechanism underlying ABPE.
  
  
  METHODS
  We retrospectively analyzed seizure profiles, scalp video EEG (VEEG) and MEG in ABPE patients.
  
  
  RESULTS
  Eighteen ABPE patients were identified (nine girls and nine boys). Seizure onset ranged from 1.3 to 8.8years (median, 2.9years). Initial seizures consisted of focal motor seizures (15 patients) and absences/atypical absences (3). Seventeen patients had multiple seizure types including drop attacks (16), focal motor seizures (16), ENM (14), absences/atypical absences (11) and focal myoclonic seizures (10). VEEG showed centro-temporal spikes and CSWS in all patients. Magnetic resonance imaging (MRI) was reported as normal in all patients. MEGSSs were localized over the following regions: both Rolandic and sylvian (8), peri-sylvian (5), peri-Rolandic (4), parieto-occipital (1), bilateral (10) and unilateral (8). All patients were on more than two antiepileptic medications. ENM and absences/atypical absences were controlled in 14 patients treated with adjunctive ethosuximide.
  
  
  CONCLUSIONS
  MEG localized the source of centro-temporal spikes and CSWS in the Rolandic-sylvian regions. Centro-temporal spikes, Rolandic-sylvian spike sources and focal motor seizures are evidence that ABPE presents with Rolandic-sylvian onset seizures. ABPE is therefore a unique, age-related and localization-related epilepsy with a Rolandic-sylvian epileptic focus plus possible thalamo-cortical epileptic networks in the developing brain of children.
authors: Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors: Hideaki
authors: H
authors: Shiraishi
authors: Department of Pediatrics, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
authors: Kazuhiro
authors: K
authors: Haginoya
authors: Department of Neurology, National Hospital for Mental, Nervous and Muscular Disorders, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
authors: Eiji
authors: E
authors: Nakagawa
authors: Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors: Shinji
authors: S
authors: Saitoh
authors: Department of Neurosurgery, National Hospital for Mental, Nervous and Muscular Disorders, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
authors: Yutaka
authors: Y
authors: Kaneko
authors: Department of Epileptology, Tohoku University School of Medicine, Sendai, Miyagi, Japan.
authors: Nobukazu
authors: N
authors: Nakasato
authors: Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada; Neurology Service, Department of Pediatric Medicine, KK Women's and Children's Hospital, Singapore.
authors: Derrick
authors: D
authors: Chan
authors: Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada. Electronic address: hiotsubo@rogers.com.
authors: Hiroshi
authors: H
authors: Otsubo
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D058256:Brain Waves / Q000187:drug effects / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D005013:Ethosuximide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography; D008297:Male; D012189:Retrospective Studies
chemical_list: D000927:Anticonvulsants; D005013:Ethosuximide
keywords: Atypical absence; Centro-temporal spike; Continuous spike and waves during sleep; Epileptic negative myoclonus; Focal seizure; Secondary bilateral synchrony