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Ann Clin Neurophysiol > Volume 19(1); 2017 > Article
CASE REPORT
Ann Clin Neurophysiol. 2017; 19(1): 58-63.
Published online January 26, 2017.
doi: https://doi.org/10.14253/acn.2017.19.1.58
EEG spikes resembling cardiac M-shaped waves in the EKG: the cerebral M pattern
A.Bruce Janati1, Naif S. ALGhasab2, Tariq Aziz3, Fazal Haq3, Fahad Saad ALGhassab4, Tariq Iqhbal3, and Rehab Khaleel Alenazy5
1Neurology Center of Fairfax, Fairfax, USA
2Department of Internal Medicine, Hail University, KFSH&RC, Saudi Arabia
3Department of Neurology, King Khalid Hospital, Hail, Saudi Arabia
4Department of Dentistry, King Khalid Hospital, Hail University, Hail, Saudi Arabia
5Department of Internal Medicine, Hail University College of Medicine, Hail, Saudi Arabia
Corresponding Author: Naif S. ALGhasab ,Tel: +966-507886878, Fax: +966-065333012, Email: Naifalghasab@gmail.com
Received June 14, 2016   Revised: September 3, 2016    Accepted September 12, 2016
Copyright © 2017 The Korean Society of Clinical Neurophysiology
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Studies of interictal epileptiform discharges are essential for improving the diagnosis, classification, and management of epilepsy. In this case series we sought to identify the clinical and neurophysiological significance of bifid spikes, whose pattern bears a strong resemblance to the cardiac M pattern. We hypothesize that, analogous to the cardiac M pattern, the cerebral M pattern is generated by a conduction defect associated with asynchronous spatiotemporal averaging of electrical signals in the cortex, resulting in the signals reaching the scalp with different latencies. Unlike the cardiac M pattern, the pathology underlying the cerebral M pattern is unknown, although congenital CNS anomalies may be a culprit.
Key words: Interictal epileptiform discharges; Bifid spikes; Cerebral M pattern
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