Sequential EEG mapping may differentiate “epileptic” from “non-epileptic” rolandic spikes

Abstract Sequential topographic mapping was performed to differentiate “epileptic” from “non-epileptic” rolandic spikes. Twenty-four children without any indication of organic brain lesion were divided into a group with epilepsy and a group without epilepsy. The group with epilepsy was subdivided into “classical BECT” (benign focal epilepsy of childhood with centro-temporal spikes) and “non-classical BECT”. Sequential mapping of the rolandic spikes revealed two different topographic patterns: a pattern of stationary potential fields and a pattern of non-stationary potential fields. The topographic pattern of stationary potential fields was morphologically represented by a single spike-and-wave complex whereas that of non-stationary potential fields was morphologically represented by a “double” spike-and-wave complex. Amomg the non-stationary topographic patterns represented by a “double” spike, one specific sequence of changes of potential fields was found. This sequence started with a dipolar field, with the negative pole in the frontal region and the positive pole in the centro-temporal region, morphologically represented by the small first spike of the “double” spike-and-wave complex. This dipolar field, changed to a unipolar or dipolar field, with a negative potential field in the centro-temporal region and, sometimes, a simultaneous positive potential field in the frontal region, morphologically represented by the prominent rolandic spike. This characteristic pattern was found to be significantly related to classical BECT.