{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T21:22:55Z","timestamp":1780694575830,"version":"3.54.1"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T00:00:00Z","timestamp":1683072000000},"content-version":"vor","delay-in-days":32,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We sought to study the spatio\u2010temporal propagation of occipito\u2010frontal spikes in childhood epilepsies by voltage mapping and dipole localization and identify types of occipito\u2010frontal spikes based on onset, propagation, and stability of their dipoles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sleep EEG data of children, aged 1\u201314\u2009years, with a minimum 1\u2009h of recording from June 2018 to June 2021, were analyzed to identify occipito\u2010frontal spikes. In total, 150 successive occipito\u2010frontal spikes were manually selected from each EEG and using a source localization software were averaged using automated pattern matching with a threshold of 80%, and sequential 3D voltage maps of averaged spike were analyzed. Stability quotient (SQ) was calculated as the total number of averages\/150. Stable dipole was defined as SQ\u2009\u2265\u2009.8. Dipole analysis was performed with principal component analysis using an age\u2010appropriate template head model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ten children with occipito\u2010frontal spikes were identified; five with self\u2010limited epilepsy with autonomic seizures (SeLEAS) and five with non\u2010SeLEAS epilepsies. Three types of occipito\u2010frontal spikes were identified: (1) narrow occipito\u2010frontal spikes with stable dipoles seen in all five children with SeLEAS which were \u201capparently\u201d synchronous and bilateral clone\u2010like with an occipito\u2010frontal interval of 10\u201330\u2009ms and a homogeneous propagation pattern from a unilateral medial parieto\u2010occipital region to an ipsilateral mesial frontal region; (2) wide occipito\u2010frontal spikes with stable dipoles seen in one child with non\u2010SeLEAS and developmental and\/or epileptic encephalopathy with spike\u2013wave activation in sleep (D\/EE\u2010SWAS) with an occipito\u2010frontal interval of 45\u2009ms, caused by focal spike propagation from a deeper temporal focus to ipsilateral peri\u2010rolandic cortex; and (3) wide occipito\u2010frontal spikes with unstable dipoles seen in four children with non\u2010SeLEAS lesional epilepsies with an occipito\u2010frontal latency of &gt;50\u2009ms and heterogeneous propagation patterns with poor intra\u2010individual dipole stability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>We successfully identified different types of occipito\u2010frontal spikes in childhood epilepsies. Although the term \u201coccipito\u2010frontal\u201d is used to describe these spikes on the 10\u201320 EEG system, true propagation from occipital to frontal regions is not necessary. It is possible to differentiate idiopathic from symptomatic cases by analyzing the stability quotient and the occipito\u2010frontal interval of occipito\u2010frontal spikes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/epd2.20009","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T07:20:23Z","timestamp":1678692023000},"page":"173-186","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Analysis of spatio\u2010temporal propagation of occipito\u2010frontal spikes in childhood epilepsies by 3D sequential voltage mapping and dipole localization"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1901-478X","authenticated-orcid":false,"given":"Neetha","family":"Balaram","sequence":"first","affiliation":[{"name":"Department of Neurology Government Medical College  Kozhikode 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