Introduction to Controversial Sharp Waves or Spike Patterns

Abstract

The designation “controversial EEG wave forms” refers to a number of EEG patterns that tend to be more frequently detected in psychiatric populations and their association with epilepsy is weak, if at all. Included under this category are the Small Sharp Spikes (SSS), the Mitten pattern, the 6–7 and 14 positive spikes (PS), the six per second spike and waves (6/s SpW), Wicket Spikes (WS), and the Rhythmic Mid-Temporal Discharges (RMTD). It is of great interest that these waveforms have generated such heated arguments and almost all of them have two designations indicative of whether or not the speaker believes they have any clinical relevance. For example, using the term Benign Epileptiform Transients of Sleep (BETS) to refer to the SSSs would indicate that the speaker does NOT believe that this wave form has any clinical relevance. For more expanded discussion please refer to Hughes and Wilson (1983) and Hughes (1994). In the next four chapters examples of these patterns are given. The most important message is that these patterns are relatively more difficult to detect particularly to the unexperienced or hurried EEG reader. Additional examples of these patterns can be found in Gibbs and Gibbs (1964).