{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T17:59:05Z","timestamp":1777571945618,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T00:00:00Z","timestamp":1712966400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin EEG Neurosci"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:p>Introduction: Frontal-predominant epileptiform discharges (EDs) include generalized spike-wave (GSW) and frontal spikes (FS). However, negative bi-frontal ED with simultaneous occipital positivity (BFOD) are rare, leading to questions regarding physiological generators. Methods: To determine the clinical significance of BFOD, electroclinical features of children with BFOD (n\u2009=\u200940) were compared to control patients with GSW (n\u2009=\u2009102) and FS (n\u2009=\u2009100). Results: Results are presented in the following order: BFOD, GSW, and FS. Epilepsy was prevalent among the groups: 95.0%, 90.2%, and 77.0%, respectively. The median age of seizure-onset did not significantly differ between groups: 3.00, 4.00, and 2.25 years, respectively. Regarding EEG background features, the BFOD group had more disorganized sleep architecture than other groups, P\u2009&lt;\u2009.005. There was a significant difference in the proportion of developmental delay (DD) between the groups ( P\u2009&lt;\u2009.005). BFOD had much higher odds of DD compared to GSW and FS groups: odds ratio (OR) (confidence interval [CI]) 19.44 [5.64, 64.05] and 3.98 [1.16, 13.34]. Furthermore, BFOD had much higher odds of severe DD compared to GSW and FS groups: 9.60 [2.75, 33.45] and 2.73 [1.03, 7.27]. A Gross Motor Function Classification System (GMFCS) score of \u2009\u2265\u20094 was more prevalent in BFOD (22.5%), than GSW (0%) and FS groups (9%). On neuroimaging, BFOD had more structural ( P\u2009&lt;\u2009.005) and multilobar structural ( P\u2009&lt;\u2009.05) abnormalities than control groups. Conclusion: Children with BFOD had particularly severe significant DD, considerable motor deficit (GMFCS\u2009\u2265\u20094), and brain structural abnormalities, often multilobar. This suggests BFOD is a marker of severe underlying brain dysfunction and not benign when encountered on routine EEG review.<\/jats:p>","DOI":"10.1177\/15500594241246505","type":"journal-article","created":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T05:18:40Z","timestamp":1712985520000},"page":"591-600","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Original Research: Clinical Significance of a Unique Pediatric EEG Configuration: Bi-Frontal Spikes With Simultaneous Bi-Occipital Positivity"],"prefix":"10.1177","volume":"55","author":[{"given":"Jacqueline","family":"Crawford","sequence":"first","affiliation":[{"name":"Department of Diagnostic Neurophysiology, BC Children's Hospital, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cassie","family":"McFarlane","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Neurophysiology, BC Children's Hospital, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7620-4868","authenticated-orcid":false,"given":"Anita N","family":"Datta","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Neurophysiology, BC Children's Hospital, Vancouver, Canada"},{"name":"Department of Pediatrics, Division of Neurology, BC Children's Hospital, Faculty of Medicine, University of British Columbia, Vancouver, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,4,13]]},"reference":[{"key":"bibr1-15500594241246505","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410370204"},{"key":"bibr2-15500594241246505","doi-asserted-by":"publisher","DOI":"10.1016\/j.eplepsyres.2015.05.011"},{"key":"bibr3-15500594241246505","doi-asserted-by":"publisher","DOI":"10.1177\/1550059413507568"},{"key":"bibr4-15500594241246505","first-page":"21","volume":"52","author":"Noachtar 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