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A case-control study of wicket spikes using video-EEG monitoring
Maya Vallabhaneni1, Laura E Baldassari, James T Scribner
1Department of Neurology, Georgetown University Hospital, Washington, DC, United States.
Purpose:
To investigate clinical characteristics associated with wicket spikes in patients undergoing long-term video-EEG monitoring.
Methods:
A case-control study was performed in 479 patients undergoing video-EEG monitoring, with 3 age- (±3 years) and gender-matched controls per patient with wicket spikes. Logistic regression was utilized to investigate the association between wicket spikes and other factors, including conditions that have been previously associated with wicket spikes.
Results:
Wicket spikes were recorded in 48 patients. There was a significantly higher prevalence of dizziness/vertigo (p=0.002), headaches (p=0.005), migraine (p=0.015), and seizures (p=0.016) in patients with wickets. The majority of patients with wicket spikes did not exhibit epileptiform activity on EEG; however, patients with history of seizures were more likely to have wickets (p=0.017). There was no significant difference in the prevalence of psychogenic non-epileptic seizures between the groups. Wickets were more common on the left, during sleep, and more likely to be first recorded on day 1-2 of monitoring.
Conclusions:
Patients with wicket spikes are more likely to have dizziness/vertigo, headaches, migraine, and seizures. Patients with history of seizures are more likely to have wickets. The prevalence of psychogenic non-epileptic seizures is not significantly higher in patients with wickets.
Insights
Wicket spikes on electroencephalograms (EEGs) are linked to increased dizziness, headaches, and seizures. Patients with a history of seizures are more prone to developing wicket spikes.
Area of Science:
- Neurology
- Clinical Neurophysiology
Background:
- Wicket spikes are an EEG pattern observed during long-term monitoring.
- Understanding their clinical associations is crucial for diagnosis and management.
Purpose of the Study:
- To investigate clinical characteristics associated with wicket spikes.
- To identify factors correlating with the presence of wicket spikes in patients undergoing video-EEG monitoring.
Main Methods:
- A case-control study involving 479 patients undergoing video-EEG monitoring.
- Matched controls were used for patients with wicket spikes.
- Logistic regression analysis was employed to assess associations.
Main Results:
- Wicket spikes were identified in 48 patients.
- Significantly higher prevalence of dizziness, vertigo, headaches, migraine, and seizures in patients with wicket spikes.
- Patients with a history of seizures were more likely to exhibit wicket spikes.
Conclusions:
- Wicket spikes are associated with increased reporting of dizziness, headaches, migraine, and seizures.
- A history of seizures is a predictor for the presence of wicket spikes.
- No significant association found between wicket spikes and psychogenic non-epileptic seizures.
