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Spike voltage topography identifies two types of frontotemporal epileptic foci

Department of Neurology, Yale University School of Medicine, New Haven, CT, and the Neurology Service, Epilepsy Center, Department of Veterans Affairs Medical Center, West Haven, CT.

We characterized voltage topography of frontotemporal EEG spikes in 24 patients with complex partial seizures and identified two distinct patterns. "Type 1" spikes possessed a "dipolar" field with a negative region over the inferolateral temporal scalp and a positive region over the contralateral, centroparietal scalp. "Type 2" spikes showed only a broad, frontotemporal negative field. One or the other spike type predominated in all but two patients. Correlations with clinical data and intracranial EEG suggest that type 2 spikes arise from temporal or frontal neocortex, while type 1 spikes involve mesial temporal structures as well as lateral cortex.

Address correspondence and reprint requests to Dr. John S. Ebersole, Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510.

Received December 17, 1990. Accepted for publication in final form February 13, 1991.

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