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Clinical relevance of a dipole field in rolandic spikes
1Department of Diagnostic Neurophysiology, British Columbia's Children's Hospital, Vancouver, Canada.
Insights
Temporal-frontal dipole discharges in children are linked to fewer clinical issues than other rolandic spikes. This finding suggests these specific EEG patterns may indicate a benign condition.
Area of Science:
- Pediatric Neurology
- Clinical Neurophysiology
Background:
- Rolandic spikes are common EEG findings in children.
- The clinical significance of different rolandic spike patterns is not fully understood.
Purpose of the Study:
- To investigate the association between temporal-frontal dipole discharges and clinical abnormalities in children.
- To compare the clinical presentation of children with temporal-frontal dipole discharges versus nondipole rolandic discharges.
Main Methods:
- Retrospective analysis of 366 children with rolandic spikes.
- Comparison of clinical parameters (birth history, development, school, seizures, neurological exam, CT) between children with temporal-frontal dipole discharges (n=99) and nondipole rolandic discharges (n=267).
Main Results:
- Children with temporal-frontal dipole discharges showed a significantly lower incidence of clinical abnormalities (p < 0.001) compared to those with nondipole discharges.
- Dipole group presented less often with frequent seizures (10% vs 55%), developmental delay (18% vs 55%), school difficulties (34% vs 60%), and abnormal neurological exams (22% vs 63%).
- Nondipole group exhibited a higher incidence of clinical abnormalities across all assessed parameters compared to controls.
Conclusions:
- Temporal-frontal dipole discharges are associated with a significantly lower incidence of clinical abnormality in children.
- These specific EEG discharges may represent a benign functional focus, differentiating them from other rolandic spikes.
Abstract:
The clinical presentation of 366 children with rolandic spikes was examined to determine whether the presence of a temporal-frontal dipole field is associated with a lower incidence of clinical abnormality. Comparisons were made between the clinical presentation of 99 children with temporal-frontal dipole discharges versus 267 children with nondipole rolandic discharges. Criteria examined were birth history, developmental milestones, school history, total number of seizures, neurological examination, and computed tomography (CT) findings. For all clinical parameters, except birth history and CT finding, there was a lower incidence of clinical abnormality in the group with dipole discharges (p less than 0.001). The clinical profile seen with temporal-frontal dipole discharges was very different than with nondipole rolandic spikes. Children with dipole discharges less often presented with frequent seizures (10%), developmental delay (18%), school difficulties (34%), or abnormal neurological exam (22%). In contrast, children with nondipole rolandic discharges often presented with a history of frequent seizures (55%), developmental delay (55%), school difficulties (60%), and an abnormal neurological exam (63%). The incidence of clinical abnormalities in the nondipole group exceeded that found in our control population in all areas. Temporal-frontal dipole discharges are associated with a lower incidence of clinical abnormality than are nondipole rolandic spikes. These discharges may represent a benign functional focus.