Clinical commentaryDistributed source localization of interictal spikes in benign childhood epilepsy with centrotemporal spikes: A standardized low-resolution brain electromagnetic tomography (sLORETA) study

- We performed distributed source localization analysis of interictal spikes in BCECTS.
- The widespread cortical distribution of interictal spikes was observed in this study.
- BCECTS is the most common benign childhood epilepsy.
- But, atypical presentation and a variety of comorbidities of BCECTS have been noted.
- It may be associated with such widespread distribution of interictal spikes.

Benign childhood epilepsy with centrotemporal spikes (BCECTS), also known as Rolandic epilepsy, is the most common benign childhood epilepsy. Centrotemporal spikes are characteristic findings on electroencephalography (EEG). Though the condition is considered benign, many studies have reported some degree of neuropsychological impairment in individuals with BCECTS. There is also growing evidence from neuroimaging studies that BCECTS may affect a larger portion of the brain than originally thought. We performed distributed source localization analysis of interictal spikes in BCECTS. Current-source density (CSD) of the maximal negative peak of the interictal spikes averaged from each of 20 EEG epochs in 11 patients with BCECTS was measured using standardized low-resolution brain electromagnetic tomography (sLORETA). Rolandic area was included in the distribution of the CSD in all of the patients. The significant CSD and its maximal point were distributed in multiple cortical regions over the Rolandic area. It is suggested that the widespread cortical distribution of interictal spikes seen in this study may be associated with atypical presentation and a variety of comorbidities of BCECTS. Our results imply that BCECTS represents a deviation from normal development during a critical period of brain maturation and that children with BECTS might be more likely to need special medical attention.