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Ann Clin Neurophysiol. 2017 Jan;19(1):58-63. English. Case Report. https://doi.org/10.14253/acn.2017.19.1.58
Janati A , ALGhasab NS , Aziz T , Haq F , ALGhassab FS , Iqhbal T , Alenazy RK .
Neurology Center of Fairfax, Fairfax, USA.
Department of Internal Medicine, Hail University, KFSH&RC, Saudi Arabia. Naifalghasab@gmail.com
Department of Neurology, King Khalid Hospital, Hail, Saudi Arabia.
Department of Dentistry, King Khalid Hospital, Hail University, Hail, Saudi Arabia.
Department of Internal Medicine, Hail University College of Medicine, Hail, Saudi Arabia.
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.

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