Sequential topographic EEG mapping performed to differentiate “epileptic” from “non-epileptic” rolandic spikes has shown a characteristic pattern significantly related to classical BECT (benign focal epilepsy of childhood with centro-temporal spikes) in a study at the Department of Clinical Neurophysiology and Department of Child Neurology, University Hospital Utrecht, The Netherlands. There were 2 patterns: 1) stationary potential fields, and 2) non-stationary potential fields. The non-stationary patterns represented by a double spike showed a specific sequence starting with a dipolar field, with the negative pole in the frontal region and the positive pole in the centro-temporal region, and changing to a unipolar or dipolar field, with a negative potential field in the centro-temporal region and a simultaneous positive potential field in the frontal region. This characteristic pattern appeared to be significantly related to classical BECT. 
COMMENT. The spike morphology in 40 uncontrolled childhood focal epilepsy patients was quantified by a computer-based technique and analyzed in relationship to epileptic syndromes at the Baylor College of Medicine, Houston, TX. The spikes of patients in the benign focal epilepsy category differed from those in other syndromes; they were higher in amplitude, longer in duration, less sharp, and had a higher spike parameter. 
A report of unilateral opercular macrogyria underlying benign childhood epilepsy with centrotemporal rolandic spikes in an 18 year old boy emphasizes the need for MRI in detecting neuronal migration disorders and other structural lesions in cases of apparent idiopathic partial epilepsies.