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Session on Clinical Neurophysiology Afternoon Meeting Thursday, April 28, 1977

Small sharp spikes have been viewed as an EEG finding of uncertain clinical significance since the original description by Gibbs and Gibbs. Both the electrographic characteristics and the symptomatic correlates of small sharp spikes have been the subject of conflicting reports for many years. In an attempt to resolve some of the confusion sumunding this entity, wake and sleep EEGs were performed on 120 normal volunteers. The findings from this control population were compared with the results obtained by reviewing EEGs obtained under similar circumstances from 599 consecutive patients referred to the Stanford University Hospital EEG Laboratory. In our study 24% of normal volunteers and 20% of the patient population had epileptiform discharges we categorized as small sharp spikes. They were characterized by their morphology; by their shifting location, with maximal amplitude usually at F7-a, PGl-z, and the ears; by their sporadic occurrence without a tendency to repetition; by the absence of admixed sharp waves or focal slowing; and by their appearance only during drowsiness and light sleep. In contrast, EEGs from 36 patients with an unequivocal clinical diagnosis of complex partial seizures revealed temporal spikes that were more usually unilateral, often appeared during wakefulness, had a more variable CNP 2 2:45