Excerpt from EEG Atlas: Epileptiform Normal Variants

Synonyms, Key Words, and Related Terms: EEG atlas, epileptiform normal variants, benign epileptiform transients of sleep, midline theta, phantom spikes and waves, psychomotor variants, small sharp spikes, SSS, subclinical rhythmic EEG discharges of adults, SREDA, wicket spikes, 14- and 6-Hz positive spikes

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Epileptiform normal variants are EEG patterns that resemble epileptogenic abnormalities. Most of these patterns initially were thought to be associated with epilepsy or other neurological conditions but subsequently were demonstrated to have no such significance. They now are considered normal variants of no clinical significance. Their recognition is important to avoid overinterpretation or misinterpretation with regard to their significance. This article reviews the following such patterns: small sharp spikes (SSS), wicket spikes, 14- and 6-Hz positive spikes, phantom spike and waves, psychomotor variants, subclinical rhythmic EEG discharges of adults (SREDA), and midline theta.

Most of these patterns initially were described in the 1950s. Gibbs and Gibbs described small sharp spikes in 1952, and 14- and 6-Hz positive spikes were described at approximately the same time (Gibbs, 1951; Grossman, 1954; Kellaway, 1959; Nidermeyer, 1961). The 6-Hz phantom spike-wave was described by Walter (1950), and the psychomotor variant was described by Gibbs and Gibbs (1952). Wickets were described in 1977 (Reiher and Lebel).

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