Electro-clinical correlations in the positive spike phenomenon

Abstract

1. 1. This investigation is concerned with the electro-clinical correlations found in 115 patients who showed 7 and 14/sec positive spikes. 2. 2. The distribution of ages of these patients shows that the positive spike phenomenon is primarily a teen-age disorder with a mean age of 15.5 years. 3. 3. The presumed etiology was head injury in 40 per cent of these patients. 4. 4. The clinical symptomatology is varied but the two major types of symptoms are behavior disorder and autonomic dysfunction; histories of some form of seizure, generally accepted as epileptiform, were obtained in 27 per cent of the cases. 5. 5. The majority of positive spikes, seen in the sleep record, are bilateral but with a right-sided predominance. Not infrequently, posterior slowing, also with a right-sided predominance, is present in the waking record. In cases showing positive spikes mainly on the left, the posterior slowing will more likely show a left-sided predominance. 6. 6. The waking records of the positive spike group and those of a group without positive spikes but with similar clinical symptomatology and matched in size, age range and average age were compared. The records of the patients with positive spikes tend to show lower frequencies of the background rhythm, more posterior slowing, more diffuse slow transients, more epileptiform sharp waves, more “build-up” with hyperventilation and poorer photic driving.