The Electroencephalographic Features of Benign Centrotemporal (Rolandic) Epilepsy of Childhood

There is no experimental model of benign rolandic epilepsy, and the neurophysiologic and molecular mechanisms involved in the generation and elaboration of this type of epilepsy and its unique electroencephalographic features have yet to be determined. These EEG features are constituted by ionic currents generated at a cellular level. They are cortical in origin, and the cortical neurons responsible for their generation must be arranged and interconnected in such a manner as to permit their synchronous or virtually synchronous activation. This capacity for synchronization is inherent in the cellular arrangement and connectivity of the cortical network itself, but also may reflect imposed synaptic influences of thalamic origin. The dominant EEG feature of benign rolandic epilepsy is a focal surface negative spike (Fig. 1) with specific biophysical characteristics. The average duration is -74 ms (leading some authors to insist that it should be referred to as a sharp wave rather than a spike). The average sharpness or degree of curvature of the peak is 0.022 pV/ms/8 ms, indicating a relatively blunt character. The average amplitude is about 160 FV (I), but some individual spikes may exceed 300 pV. The high amplitude, the relatively prolonged duration, and the bluntness of the spike suggest that it is generated