In order to test an hypothesis that slow spike and wave formations may be only the immature form of the 3/sec. dart and dome formation of "petite absence" and to learn more about the meaning of a dysrhythmia that consists of an alternation of wave frequency, a comparison was made of the clinical histories and examinations of 200 patients belonging to each group. The group with the slow pattern contained relatively more males; the patients were younger both when seizures began and at the time of examination, their history contained a greater variety of seizure phenomena and their EEGs more associated abnormalities. The evidence of brain damage that antedated seizures was much greater and the family history of epilepsy was somewhat less in the slow group as contrasted with the fast; and yet, heredity played as great a part in the slow group as in a large unselected group of "genetic" epileptics. Intelligence of the slow group was lower than that of the fast. Slow spike-hump discharges are more diverse in configuration and distribution, more often localized and solitary than dart-dome discharges. The slow form is less often identified with specific clinical symptoms, though in this group of children, 53% had a history of one or more of the petit mal quartette. Astatic (akinetic) falls or simple or massive myoclonic jerks may accompany solitary discharges. Massive jerks were confined to the very young. Of the infants, 55% had this form. Periods of sudden stillness, staring, sagging, small jerkings or mild tonicity, often without full loss of consciousness, may be the clinical correlates of serial discharges. Though less responsive to tridione® or other therapy than the faster variety, control of seizures and even of this peculiar spike-hump dysrhythmia may be possible.

Intraluminal pressure in the duodenum has been recorded in infants and children utilizing a strain gauge transducer and an open tube method. This method was used in a group of 31 normal children, 11 children with cystic fibrosis of the pancreas and 6 with the celiac syndrome. All the waves of the duodenum could be divided into two main wave forms. The most frequent wave seen was of a duration of less than 8 seconds, classified as a type I wave. Such waves occurred in both rhythmic and non-rhythmic bursts with a consistent frequency of 12 waves/min. The non-rhythmic type I wave was the most common wave form observed in the duodenal motility of children. The second wave form, type III, consisted of an elevation of the base-line longer than 8 seconds in duration with superimposed type I waves and a frequency of 96.8 waves/hr. No significant difference was present in the three groups in both total wave activity and in the incidence of specific wave types. Duodenal motility resulting from a milk feeding of 60 ml was studied in 16 normal children and 5 with cystic fibrosis of the pancreas. A significant response in total activity resulting from a rise in the number of non-rhythmic type I waves followed milk ingestion. Concurrent with the rise in total activity and non-rhythmic type I waves seen after ingestion of milk, there was a significant decline in the rhythmic type I wave bursts. The response to 0.1 mg/kg dose of bethanichol chloride injected subcutaneously was observed in 10 normal children. A significant increase in total activity, manifested principally by a rise in the non-rhythmic type I waves, was demonstrated. At the same time there was a significant decrease in the incidence of type I rhythmic wave bursts and type III waves. The duodenal motility of children had a higher incidence of type I rhythmic wave bursts and frequency of non-rhythmic waves than the duodenal motility reported previously in adults. Under the conditions of this experimental method there was a lower incidence of non-rhythmic type I waves and type III waves in children compared to the results reported in adults.

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