Wicket spikes: a case-control study of a benign eletroencephalografic variant pattern

Abstract

-Wicket spikes (WS) are a benign eletroencephalogram (EEG) variant, seen mainly in adults, during somnolence, in the temporal regions, in many clinical situations. WS can appear in trains or isolatedly, sometimes being difficult to differentiate from epileptiform activity. We reviewed 2,000 EEG's, found 65 with WS (3.25%) and compared them with 65 normal EEG without WS. There was statistically significant (SS) association between WS and age over 33; adolescent age was correlated to absence of WS and age over 65, to the presence of WS; there was an inverse correlation between WS and epilepsy, related to differences in age; a SS association with cerebrovascular disorders disappeared after controlling for age; a SS correlation with headache was also related to age; female predominance was not SS. There was a great variety of clinical situation associated with WS. We conclude that WS are a inespecific normal variant of the EEG that is age-related.KEY WORDS: Wicket spikes, benign variants, eletrotroencephalogram. "Wicket spikes": estudo de variante eletrográfica benignaRESUMO -As Wicket spikes (WS) são um padrão benigno, variante da normalidade do eletrencefalograma (EEG), vistas principalmente em adultos, durante a sonolência, nas regiões temporais, em situações clínicas variadas. WS aparecem em "trens" ou isoladamente, podendo ser difícil diferenciá-las de atividade epileptiforme. Nós revisamos 2.000 EEG e encontramos 65 com WS (3,25%) e os comparamos a 65 EEG 's normais sem WS. Encontramos associação estatisticamente significante (ES) entre WS e idade acima de 33 anos; adolescência e ausência de WS e idade acima de 65 e presença de WS. Houve correlação inversa entre WS e epilepsia, explicada por diferenças nas médias de idade. A correlação ES entre WS e doença cerebrovascular desapareceu após controlarmos a idade. A correlação ES a cefaléia dependeu de sua relação à idade. A predominância do sexo feminino não foi ES. Houve maior variedade de situações clínicas associadas a WS. WS são uma variante normal do EEG, idade-relacionada.

Standard EEG: A Research Roadmap for Neuropsychiatry

“…They concluded that WS are nonspecific normal variant of the EEG that is age-related. Furthermore, Batista et al (1999) noted a left temporal preponderance of WS as well as documenting phase reversal in that region indicating a surface negativity similar to most pathological EEG abnormalities. Reither and had already documented the surface negativity of the WS.…”

“…There is some predilection for being left sided (Niedermeyer and Lopes da Silva 2005). Batista et al (1999) asserted that while WS can appear sporadically, they, in general, present a smooth increase in amplitude, ranging from 60 to 200 lV, followed by an abrupt decrease in amplitude, to finally reach the pre-burst baseline. When appearing as isolated spikes, it tends to have a negative potential resulting in the phase reversal appearance which is usually taken as evidence of pathogenicity ( Fig.…”

“…On the other hand, and a seemingly more careful study where only subjects with awake and asleep records were included Reiher and Lebel (1977) from 4,458 also neurology-based laboratory referrals through the years 1969-1975, WS were detected in 39 patients (0.9 %). Batista et al (1999) reviewed 2,000 EEG's from EEG laboratory referrals, found 65 with WS (3.25 %). This is the highest rate reported in the literature.…”

“…The authors found no correlation with the tonic or phasic phases of REM sleep. Batista et al (1999) while stating that WS are a benign EEG variant, they also asserted that they are seen in many clinical situations. They compared WS patients with 65 patients with normal EEG without WS.…”

A case–control study of wicket spikes using video-EEG monitoring

“…[1][2][3][4] The incidence of wicket spikes has been reported at 0.8-3.25% based on regular EEG records. 1,5,6 Wicket spikes were originally described by Reiher and Lebel as benign temporal discharges resembling mu rhythm or epileptic spikes recorded during both wakefulness and sleep in 39 out of 4458 EEGs. The authors concluded that wicket spikes should not be considered epileptiform or abnormal, given the absence of clinical association with epilepsy or any particular symptom complex.Additionally, symptoms such as syncope, headache, or vertigo were reported in 80% of the patients with wicket spikes.…”