Electroclinical significance of rolandic spikes and dipoles in neurodevelopmentally normal children

Abstract

“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.