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Intracranial correlates of small sharp spikes
Nino Epitashvili1, Victoria San Antonio-Arce1, Armin Brandt1
1Epilepsy Center, Medical Center, Faculty of Medicine, University of Freiburg, Breisacher Str. 64, 79106 Freiburg im Breisgau, Germany.
Summary
Scalp small sharp spikes (SSS) originate from focal epilepsy, often in the temporal lobe, and are not benign EEG events. This study identified their heterogeneous intracranial generators.
Area of Science:
- Neuroscience
- Epileptology
- Clinical Electrophysiology
Background:
- Scalp small sharp spikes (SSS) are EEG patterns with unclear origins.
- Previous research has not definitively established the intracranial sources of SSS.
Purpose of the Study:
- To investigate the cortical correlates of scalp small sharp spikes (SSS) using simultaneous scalp and intracranial EEG recordings.
- To determine if SSS have an epileptic origin and identify their generators.
Main Methods:
- Retrospective analysis of 33 patients with simultaneous scalp and intracranial EEG recordings.
- Identification of SSS in scalp EEG and analysis of co-occurring intracranial potentials.
Main Results:
- SSS correlates were found in the temporal lobe in almost all patients, predominantly in the hippocampus.
- Intracranial spikes co-occurring with SSS had significantly higher amplitudes than those without scalp correlates.
- In 45% of patients, intracranial spikes associated with SSS were located within the seizure onset zone (SOZ).
Conclusions:
- The findings strongly support an epileptic origin for SSS.
- SSS represent heterogeneous generators within the brain.
- Scalp small sharp spikes should be considered an EEG manifestation of focal epilepsy, not necessarily benign.
