Spike Morphology, Location, and Frequency in Benign Epilepsy With Centrotemporal Spikes

Abstract

The literature on benign epilepsy with centrotemporal spikes reports a constellation of neurophysiologic features in selected populations with heterogeneous methodologies. The aim of this study was to determine the specific electroencephalographic (EEG) features (spike morphology, location, and frequency and associated background slowing) in a broad population-based cohort identified through EEG laboratories. The mean spike frequency in the awake state was 9.3 per minute (95% confidence interval 6.5-12.0), in drowsiness, 21.2 per minute (16.7-25.6); and in sleep, 45.6 per minute (38.3-52.8), where 60% of patients had > 40 discharges per minute. In five patients, spike train rates occupied > 80% of the sleep record, and in nine patients, they occupied 61% to 80%. An ambulatory overnight record did not add new information comparing early-onset sleep with a mean spike frequency of 37.1 per minute (27.3-46.9) with slow-wave sleep, 36.0 per minute (27.3-44.7). Patients with benign epilepsy with centrotemporal spikes have a high spike burden, which can impact on cognitive function.

EEG Characteristics Related to Educational Impairments in Children with Benign Childhood Epilepsy with Centrotemporal Spikes

“…Possibly the high frequency of children already using medication at the moment they were analyzed in Kempenhaeghe, especially in case of carbamazepine, which can lead to an aggravation of interictal activity (Gross‐Selbeck, 1995), disturbs the distribution of epileptiform activity during wake and sleep. However, also in the study by Massa et al (2001) and in the study by Berroya et al (2005), 66% respectively 58% of children used antiepileptic drugs at time of the 24 hour EEG recording. These percentages are equal to the 67% of children using medication in our study.…”

“…In general, spike frequency increases in non‐REM sleep. Spike amplitude increases and spikes become more diffuse involving adjacent areas and sometimes the centrotemporal area of the contralateral hemisphere (Blom and Heijbel, 1975; Dalla Bernardina and Beghini, 1976; Beydoun et al, 1992; Pan and Luders, 2000; Berroya et al, 2005). The presence of the different EEG phenomena in wakefulness and sleep is summarized in Table 5.…”

“…The second part of this study is focused on improvement of the methods to analyze the relevant EEG criteria related to educational and behavioral impairments. Recently, Berroya et al described that in children with BCECTS a routine EEG including sleep onset provides information similar to a whole night recording, regarding the determination of nocturnal spike frequency (Berroya et al, 2005). However, due to the study design, mainly EEG recordings from children with uncomplicated BCECTS were analyzed and the atypical EEG criteria were not scored.…”

Reduced Structural Connectivity between Sensorimotor and Language Areas in Rolandic Epilepsy

“…For this, criteria from literature were used [2], [15]. EEG criteria included the presence of spike and slow wave complexes occurring as individual paroxysms or in repetitive clusters with a maximum in the mid temporal and/or central electrodes and with a temporal-frontal dipole field.…”

Early onset of cortical thinning in children with Rolandic epilepsy

“…Children with RE were selected based on EEG criteria and seizure semiology (Berroya et al, 2005;Panayiotopoulos et al, 2008). EEG criteria include the presence of spike and slow wave complexes occurring as individual paroxysms or in repetitive clusters with a maximum in the mid temporal and/or central electrodes and with a temporal-frontal dipole field.…”