Positive rolandic sharp waves in the electroencephalograms of premature neonates with intraventricular hemorrhage.

Seventy-eight electroencephalograms (EEGs) recorded from 44 premature infants with documented intraventricular hemorrhage (IVH) were retrospectively reviewed. Positive rolandic sharp waves (PRS) were observed in 13 of 44 (29.5%) patients. Among infants with grades 3 and 4 IVH, the incidence of PRS was 60% (9 of 15). During the period of study, typical PRS appeared in two EEGs of one premature infant who did not suffer an IVH. PRS were usually associated with moderately abnormal EEG backgrounds and with grades 3 and 4 IVH. Beta activity was superimposed on an average of 21.5% of PRS (beta-PRS). Infants with grades 3 and 4 IVH had a higher incidence of beta-PRS than those with smaller hemorrhages. PRS first appeared in early postnatal life, increased in abundance and then eventually disappeared from the records by 3-4 weeks of age. The field of distribution of PRS was centered at the central parasagittal region (Cz) with generous anteroposterior spread into the frontal and parietal vertices (Fz and Pz) and symmetric lateral spread into the rolandic areas (C3 and C4). Asymmetric involvement of PRS at C3 and C4 may signify differential hemispheric injury. The majority of infants whose EEGs contained PRS died or suffered serious neurologic sequelae. However, their outcomes were not significantly inferior to those without PRS.