Clinical application of dipole models in the localization of epileptiform activity.

SUMMARY: Routine clinical interpretation of EEG using visual inspection of traces is a time-honored, but simplistic, form of analysis. This is particularly true in attempts to localize an epileptogenic focus by means of EEG spike or seizure waveforms. Improved understanding of the cortical substrates of these potentials has allowed us to identify their likely cerebral origins through spatio-temporal analysis of scalp voltage fields. Equivalent dipole modeling is one such technique. Although an imperfect representation of spike or seizure sources, proper interpretation of dipole models can lead to a far better characterization of their localization and propagation. Modern techniques of 3-D MRI reconstruction and realistic head models have both improved localization accuracy and provided a means of displaying results in an image of the individual's brain.