Positive Spikes Revisited — in the Adult

Hughes, John R.; Cayaffa, Juan J.

doi:10.1177/155005947800900201

Cited by 15 publications

(5 citation statements)

References 6 publications

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“…196 A later study showed that their presence is a sign of normal brain activity indicating a healthier brain in this group of patients. 197 As for many normal variants, this pattern was thought in the early days to be associated with various psychiatric conditions and epilepsy, 134,179,198,199 but it is now recognized as a benign EEG variant with no epileptogenic or pathologic significance.…”

Section: Rhythmic Midtemporal Theta (Bursts) Of Drowsiness (Rmtd)mentioning

confidence: 99%

Normal variants and artifacts: Importance in EEG interpretation

Amin

Nascimento

Karakis

et al. 2023

Epileptic Disorders

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Overinterpretation of EEG is an important contributor to the misdiagnosis of epilepsy. For the EEG to have a high diagnostic value and high specificity, it is critical to recognize waveforms that can be mistaken for abnormal patterns. This article describes artifacts, normal rhythms, and normal patterns that are prone to being misinterpreted as abnormal. Artifacts are potentials generated outside the brain. They are divided into physiologic and extraphysiologic. Physiologic artifacts arise from the body and include EMG, eyes, various movements, EKG, pulse, and sweat. Some physiologic artifacts can be useful for interpretation such as EMG and eye movements. Extraphysiologic artifacts arise from outside the body, and in turn can be divided into the environments (electrodes, equipment, and cellphones) and devices within the body (pacemakers and neurostimulators). Normal rhythms can be divided into awake patterns (alpha rhythm and its variants, mu rhythm, lambda waves, posterior slow waves of youth, HV‐induced slowing, photic driving, and photomyogenic response) and sleep patterns (POSTS, vertex waves, spindles, K complexes, sleep‐related hypersynchrony, and frontal arousal rhythm). Breach can affect both awake and sleep rhythms. Normal variants or variants of uncertain clinical significance include variants that may have been considered abnormal in the early days of EEG but are now considered normal. These include wicket spikes and wicket rhythms (the most common normal pattern overread as epileptiform), small sharp spikes (aka benign epileptiform transients of sleep), rhythmic midtemporal theta of drowsiness (aka psychomotor variant), Cigánek rhythm (aka midline theta), 6 Hz phantom spike–wave, 14 and 6 Hz positive spikes, subclinical rhythmic epileptiform discharges of adults (SREDA), slow‐fused transients, occipital spikes of blindness, and temporal slowing of the elderly. Correctly identifying artifacts and normal patterns can help avoid overinterpretation and misdiagnosis. This is an educational review paper addressing a learning objective of the International League Against Epilepsy (ILAE) curriculum.

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Section: Rhythmic Midtemporal Theta (Bursts) Of Drowsiness (Rmtd)mentioning

confidence: 99%

Normal variants and artifacts: Importance in EEG interpretation

Amin

Nascimento

Karakis

et al. 2023

Epileptic Disorders

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“…2 Subsequently, many electroencephalographers have positively identified this pattern in many young children in various case studies and scenarios. [3][4][5][6][7][8][9][10][11][12] Gibbs and Gibbs had originally coined the term 6 and 14 Hz positive spikes because the pattern comes in a frequency of either 6 or 14 Hz. 13 The term positive spikes denote spiky morphology and positive polarity at the site of origin of the pattern.…”

Section: Historical Background and Nomenclaturementioning

confidence: 99%

6 and 14 Hz Positive Spikes on Scalp Electroencephalogram

Sanariya

Garg

et al. 2018

International Journal of Epilepsy

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Benign epileptiform variants (BEVs) are often noted in routine electroencephalogram (EEG) monitoring and are sometimes misinterpreted as epileptiform discharges. Six and 14 Hz positive spikes are one of such BEVs seen especially in children. However, these variants can also be seen in intensive care unit EEG recordings. Here, we have reviewed the history and electrical details of these 6 and 14 Hz variants with their clinical significance. AbstractKeywords ► EEG ► benign epileptiform variants ► 6 and 14 Hz Int J Epilepsy 2018;5:9-12

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“…When this was done they found the elevated incidence of PS among adult psychiatric admissions compared to the adult normal population to be overwhelmingly significant at all age categories (age 20-24, 27.4 vs. 8.7 %, X 2 = 31.8 , p \ 0.0000001; age 25-29, 20.9 vs. 1.3 % X 2 = 17.9, p = 0.00002; age 30-39, 13.3 vs. 0.9 %, X 2 = 14.8, p = 0.002; age 40 to 49, 7.4 vs. 0.0 %, X 2 = 6.97, p = 0.01, and age 50 to 59, 4.6 vs. 0.0 %, X 2 = 3.67, p = 0.056). In another study specifically addressing the issue of PS in an adult population (Hughes and Cayaffa 1978), 460 adults aged 30 to over 80 with PS were contrasted with a variety of comparison groups matched for age, gender, and race. Neurovegetative or psychiatric symptoms, either occurring separately or combined, were present in 85 % of the adults with PS and the authors concluded by arguing for the clinical significance of PS when encountered in the adult patient.…”

Section: Incidence In Adultsmentioning

confidence: 99%

“…Thus in adults PS frequently appear in the waking record. Hughes and Cayaffa (1978) investigated a large number of adults with PS. This study involved 460 adults from the third to the eighth decade with PS, found after screening more than 50,000 patients.…”

Section: Incidence In Adultsmentioning

confidence: 99%

Standard EEG: A Research Roadmap for Neuropsychiatry

Boutros¹

2013

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Positive Spikes Revisited — in the Adult

Cited by 15 publications

References 6 publications

Normal variants and artifacts: Importance in EEG interpretation

Normal variants and artifacts: Importance in EEG interpretation

6 and 14 Hz Positive Spikes on Scalp Electroencephalogram

Standard EEG: A Research Roadmap for Neuropsychiatry

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