Dipole reversal: an ictal feature in a patient with benign partial epilepsy of childhood with centrotemporal spike

Silva, Délrio F.; Lima, Márcia Marques; Anghinah, Renato; Zanoteli, Edma R; Lima, José Geraldo C.

doi:10.1590/S0004-282X1995000200015

Abstracts

We describe the case of a 15-year-old boy who had the diagnosis of benign partial epilepsy of childhood with centrotemporal spike. During the EEG a subclinical electrographic seizure was recorded. The discharges were clearly electropositive in T4 with positive phase reversal between derivations F8-T4 and T4-T6. The whole episode lasted less than one minute (45 sec). The interictal right medio-temporal spikes reemerged after 60 sec and were electronegative in the same location after the end of the electrographic seizures. The mechanisms underlying this uncommon pattern on EEG is not well stablished.

EEG; dipole reversal; benign partial epilepsy of childhood with centrotemporal spike

Relatamos o caso de um menino de 15 anos com o diagnóstico de epilepsia parcial benigna da infância com ponta centrotemporal. Durante o EEG uma crise eletrográfica subclínica foi gravada. As descargas estavam eletropositivas em T4 com reversão de fase positiva entre as derivações F8-T4 e T4-T6. O episódio durou menos que um minuto (45 seg). As espículas inter-ictais, na região temporal média direita, reapareceram 60 seg após e estavam eletronegativas na mesma região depois do término da crise eletrográfica. O mecanismo subjacente a este padrão incomum no EEG não está bem estabelecido.

EEG; reversão de dipolo; epilepsia parcial benigna da infância com ponta centrotemporal

Dipole reversal: an ictal feature in a patient with benign partial epilepsy of childhood with centrotemporal spike

Reversão de dipolo: um achado crítico em um paciente com epilepsia parcial benigna da infância com ponta centrotemporal

Délrio F. Silva^I; Márcia Marques Lima^II; Renato Anghinah^II; Edma R Zanoteli^III; José Geraldo C. Lima^IV

^IHead of the EEG Sector, Escola Paulista de Medicina (EPM)

^IIJunior Doctor of the EEG Sector

^IIIResident in Neurology

^IVFull Professor and Head of the Discipline of Neurology, EPM

SUMMARY

We describe the case of a 15-year-old boy who had the diagnosis of benign partial epilepsy of childhood with centrotemporal spike. During the EEG a subclinical electrographic seizure was recorded. The discharges were clearly electropositive in T4 with positive phase reversal between derivations F8-T4 and T4-T6. The whole episode lasted less than one minute (45 sec). The interictal right medio-temporal spikes reemerged after 60 sec and were electronegative in the same location after the end of the electrographic seizures. The mechanisms underlying this uncommon pattern on EEG is not well stablished.

Key words:EEG, dipole reversal, benign partial epilepsy of childhood with centrotemporal spike.

RESUMO

Relatamos o caso de um menino de 15 anos com o diagnóstico de epilepsia parcial benigna da infância com ponta centrotemporal. Durante o EEG uma crise eletrográfica subclínica foi gravada. As descargas estavam eletropositivas em T4 com reversão de fase positiva entre as derivações F8-T4 e T4-T6. O episódio durou menos que um minuto (45 seg). As espículas inter-ictais, na região temporal média direita, reapareceram 60 seg após e estavam eletronegativas na mesma região depois do término da crise eletrográfica. O mecanismo subjacente a este padrão incomum no EEG não está bem estabelecido.

Palavras-chave: EEG, reversão de dipolo, epilepsia parcial benigna da infância com ponta centrotemporal.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Aceite: 2-janeiro-1995.

Dr. Délrio Façanha da Silva - Disciplina de Neurologia, Setor de Eletrencefalografia, Escola Paulista de Medicina - Rua Botucatu 740 - 04023-900 São Paulo SP - Brasil.

1. Ambrosetto G, Gobbi G. Benign epilepsy of childhood with rolandic spikes, or a lesion? EEG during a seizure. Epilepsia 1975, 16:793-796.
2. Blume WT. Atlas of pediatric electroencephalographic. New York: Raven Press, 1982, p 144-145.
3. Bouloche J, Husson A, Le Luyer B, Le Roux P. Dysphagie, troubles du langage et pointes ondes centro-temporales. Arch Fr Pediatr 1990, 47:115-117.
4. Caspers H. DC potentials recorded directly from the cortex. In Gastaut H, Tassinari CA (eds). Handbook of electroencephalography and clinical neurophysiology, vol. 10A. Amsterdam: Elsevier, 1974, p 66-77.
5. Colamaria V, Sgro V, Caraballo R, Simeone M, Zullini E, Fontana E, Zanetti R, Grimau-Merino R, Dalla Bernardina B. Status epilepticus in benign rolandic epilepsy manifesting as anterior operculum syndrome. Epilepsia 1991, 32:329-334.
6. Dalla Bernardina B, Tassinari CA. EEG of a nocturnal seizure in a patient with benign epilepsy of childhood with rolandic spikes. Epilepsia 1975, 16:497-501.
7. Dreifuss FE, Martinez-Lage M, Roger J, Seino M, Wolf P, Dam M. Proposal for classification of epilepsies and epileptic syndromes. Epilepsia 1985, 26:268-278.
8. Faure J, Loiseau P. Une correlation clinique particuličre des pointes-ondes sans signification focale. Rev Neurol (Paris) 1960, 102:399-406.
9. Fejerman N, Di Blasi M. Status epilepticus of benign partial epilepsies in children: report of two cases. Epilepsia 1987, 28:351-355.
10. Gibbs FA, Gibbs EL. Atlas of electroencephalography, vol 2. Mass: Addison-Wesley, 1952, p 214-222.
11. Gumnit R, Takahashi T. Changes in direct current activity during experimental focal seizures. Electroenceph Clin Neurophysiol 1965, 19:63-74.
12. Gutierrez AR, Brick JF, Bodensteiner J. Dipole reversal: an ictal feature of benign partial epilepsy with centrotemporal spikes. Epilepsia 1990, 31:544-548.
13. Lerman P. Benign partial epilepsy with centro-temporal spikes. In Roger J, Dravet C, Bureau M, Dreifuss FE, Wolf P (eds). Epileptic syndromes in infancy, childhood and adolescence. London: John Libbey Eurotext, 1985, p 152-158.
14. Matsumoto H, Ajmone-Marsan C. Cellular mechanisms in experimental epileptic seizures. Science 1964, 144:193-194.
15. Morikawa T, Osawa T, Higashi T, Seino M, Wada T. A study of the sylvian seizure by the use of VTR-EEG monitoring system. Clin Neurol 1980, 22:675-679.
16. Septien L, Gras P, Giroud M, Dumas R. Syndrome bi-operculaire antérieur aigu d'origine critique dans l'epilepsie a paroxysmes rolandiques. Rev Neurol (Paris) 1992, 148:712-714.
17. Shorvon SD. The routine EEG. In Dam M, Gram L (eds). Comprehensive epileptology. New York: Raven Press, 1990, p 321-338.
18. Sorel L, Rucquoy-Ponsar M. L'epilepsie fonctionnelle de maturation: apport des montages verticaux en EEG dans le diagnostic de cette forme d'epilepsie. Rev Neurol (Paris) 1969, 121:288-297.

Publication Dates

Publication in this collection
20 Jan 2011
Date of issue
June 1995

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Ambrosetto G, Gobbi G. Benign epilepsy of childhood with rolandic spikes, or a lesion? EEG during a seizure. Epilepsia 1975, 16:793-796.

[2] 2. Blume WT. Atlas of pediatric electroencephalographic. New York: Raven Press, 1982, p 144-145.

[3] 3. Bouloche J, Husson A, Le Luyer B, Le Roux P. Dysphagie, troubles du langage et pointes ondes centro-temporales. Arch Fr Pediatr 1990, 47:115-117.

[4] 4. Caspers H. DC potentials recorded directly from the cortex. In Gastaut H, Tassinari CA (eds). Handbook of electroencephalography and clinical neurophysiology, vol. 10A. Amsterdam: Elsevier, 1974, p 66-77.

[5] 5. Colamaria V, Sgro V, Caraballo R, Simeone M, Zullini E, Fontana E, Zanetti R, Grimau-Merino R, Dalla Bernardina B. Status epilepticus in benign rolandic epilepsy manifesting as anterior operculum syndrome. Epilepsia 1991, 32:329-334.

[6] 6. Dalla Bernardina B, Tassinari CA. EEG of a nocturnal seizure in a patient with benign epilepsy of childhood with rolandic spikes. Epilepsia 1975, 16:497-501.

[7] 7. Dreifuss FE, Martinez-Lage M, Roger J, Seino M, Wolf P, Dam M. Proposal for classification of epilepsies and epileptic syndromes. Epilepsia 1985, 26:268-278.

[8] 8. Faure J, Loiseau P. Une correlation clinique particuličre des pointes-ondes sans signification focale. Rev Neurol (Paris) 1960, 102:399-406.

[9] 9. Fejerman N, Di Blasi M. Status epilepticus of benign partial epilepsies in children: report of two cases. Epilepsia 1987, 28:351-355.

[10] 10. Gibbs FA, Gibbs EL. Atlas of electroencephalography, vol 2. Mass: Addison-Wesley, 1952, p 214-222.

[11] 11. Gumnit R, Takahashi T. Changes in direct current activity during experimental focal seizures. Electroenceph Clin Neurophysiol 1965, 19:63-74.

[12] 12. Gutierrez AR, Brick JF, Bodensteiner J. Dipole reversal: an ictal feature of benign partial epilepsy with centrotemporal spikes. Epilepsia 1990, 31:544-548.

[13] 13. Lerman P. Benign partial epilepsy with centro-temporal spikes. In Roger J, Dravet C, Bureau M, Dreifuss FE, Wolf P (eds). Epileptic syndromes in infancy, childhood and adolescence. London: John Libbey Eurotext, 1985, p 152-158.

[14] 14. Matsumoto H, Ajmone-Marsan C. Cellular mechanisms in experimental epileptic seizures. Science 1964, 144:193-194.

[15] 15. Morikawa T, Osawa T, Higashi T, Seino M, Wada T. A study of the sylvian seizure by the use of VTR-EEG monitoring system. Clin Neurol 1980, 22:675-679.

[16] 16. Septien L, Gras P, Giroud M, Dumas R. Syndrome bi-operculaire antérieur aigu d'origine critique dans l'epilepsie a paroxysmes rolandiques. Rev Neurol (Paris) 1992, 148:712-714.

[17] 17. Shorvon SD. The routine EEG. In Dam M, Gram L (eds). Comprehensive epileptology. New York: Raven Press, 1990, p 321-338.

[18] 18. Sorel L, Rucquoy-Ponsar M. L'epilepsie fonctionnelle de maturation: apport des montages verticaux en EEG dans le diagnostic de cette forme d'epilepsie. Rev Neurol (Paris) 1969, 121:288-297.