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Positive rolandic sharp waves in the EEG of the premature infant

Departments of Neurology, Division of Pediatric Neurology (Drs. Novotny and Tharp) and Radiology (Dr. Enzmann), Stanford University Medical Center, Stanford, CA; and the Departments of Pediatrics (Drs. Coen and Vaucher) and Radiology (Dr. Bejar), University of California, San Diego Medical Center, San Diego, CA.

Ninety-seven EEGs from 30 premature infants found to have multifocal white matter necrosis on ultrasound (US) or autopsy were reviewed retrospectively. Twenty infants had intraparenchymal echodensities on US that developed into cystic lesions, a finding consistent with periventricular leukomalacia; 8 had intraparenchymal hemorrhages; and 2 had white matter necrosis at autopsy. Four of these infants had no intraventricular hemorrhage. Positive sharp waves in the central (rolandic) regions (PRS) were identified in 22 of these 30 infants (73%) and in 0 of 30 age-matched controls (p < 0.001). The presence of PRS on the EEG of the premature infant has a high correlation with white matter necrosis rather than with intraventricular hemorrhage. In all cases, this EEG pattern was present prior to the development of cavitations when echodensities were present on US.

Address correspondence and reprint requests to Dr. Novotny, Department of Neurology, LCI 710, Yale University, 333 Cedar Street, New Haven, CT 06511.

Presented in part at the thirty-eighth annual meeting of the American Academy of Neurology, New Orleans, LA, April 1986.

Supported in part by a clinical research fellowship from the Epilepsy Foundation of America and grant T32-NS07280 from the NIH awarded to E.J. Novotny; also in part by NIH grant NS12151 and by a Premature Research Center Grant RR-00081.

Received September 8, 1986. Accepted for publication in final form December 25, 1986.

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