Topographic mapping and clinical analysis of benign childhood epilepsy with centrotemporal spikes

We studied the topographic mapping of the electroencephalography (EEG) of 47 children whose clinical history and course were compatible with typical benign childhood epilepsy with centrotemporal spikes (BCECT). Twenty-nine (62%) patients showed typical dipole fields, with a negative potential field in the centrotemporal region and a positive field in the frontal region. Eighteen children did not demonstrate the typical dipole field. Their non-dipole rolandic discharges were localized in small fields of centrotemporal region. The patients with dipole fields in BCECT had significantly less frequent seizures than patients without dipole fields. Twelve of the 47 patients with BCECT (26%) had more than one EEG focus. The clinical courses of patients with multiple foci were not worse than those of patients with a single focus. We conclude that EEG topographic mapping is helpful in identifyiing typical or atypical EEG topographic patterns in patients with clinically diagnosed BCECT. We also conclude that the presence of dipole field usually indicates a better clinical course of epilepsy and multiple foci do not mean a poor clinical course.