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Small sharp spikes revisited: further data on this controversial pattern.

J R Hughes, G Gruener

    Clinical EEG (Electroencephalography)
    |October 1, 1984
    PubMed
    Summary
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    Small sharp spikes (SSS) on EEG are not a normal finding and are linked to a moderate risk of seizures (sz). This risk decreases with age and may resolve if the SSS pattern disappears.

    Area of Science:

    • Neurology
    • Clinical Neurophysiology

    Background:

    • Small sharp spikes (SSS) are an EEG pattern with debated clinical significance.
    • Previous studies have not definitively established the association between SSS and seizure activity.

    Purpose of the Study:

    • To investigate whether small sharp spikes (SSS) on electroencephalogram (EEG) are associated with seizures (sz) or represent a normal finding.
    • To determine the epileptogenic potential and age-dependency of SSS.

    Main Methods:

    • Retrospective analysis of EEG data from a tertiary epilepsy center.
    • Comparison of seizure incidence in patients with SSS versus those with normal EEGs or other paroxysmal abnormalities.
    • Longitudinal follow-up of patients to assess changes in SSS patterns and seizure activity over time.

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    Main Results:

    • Patients with SSS showed a significantly higher incidence of clinical seizures (48%) compared to those with normal EEGs (15%).
    • The incidence of seizures in SSS patients was lower than in those with SSS and other paroxysms (78%).
    • Seizures in SSS patients were more frequently partial compared to seizures associated with normal EEGs.
    • Seizure frequency decreased significantly when abnormal EEG records with other paroxysms normalized, but not when replaced by SSS.
    • Resolution of SSS patterns over time correlated with seizure resolution, unlike in patients who continued to exhibit SSS.
    • An inverse relationship was observed between seizure incidence and age in patients with SSS.

    Conclusions:

    • Small sharp spikes (SSS) are not a normal EEG finding.
    • SSS represent an age-dependent pattern with a moderate degree of epileptogenicity.
    • The presence and persistence of SSS are associated with ongoing seizure activity.