Positive Spikes Revisited - in the Adult

1. This study involved 460 adults from the third to the eighth decade with 6-7 and 14/sec positive spikes found among more than 50,000 patients. Comparison groups were matched for age, sex and race and included (1) a random hospital population, (2) those with normal EEGs, (3) those with abnormal EEGs and (4) patients without evidence of organic brain disease. 2. In the positive spike group the male:female ratio was 32:68; neurovegetative (61%) and psychiatric (41%) types of complaints were often found, one or the other, in 85% of the adults with this waveform. The incidence of neurovegetative complaints was greater than in all comparison groups, except those with normal EEGs and the number of psychiatric complaints was greater than the random hospital controls and less than the normal EEG group. Clear clinical seizures were found in 11%, but 65% of these latter patients had other paroxysmal abnormalities in their record to account for the attacks. 3. In adult females with positive spikes, neurovegetative complaints were found especially in the 20's and psychiatric complaints in the 50's. 4. Headaches (especially in females in the 20's), dizzinesslvertigo (especially in males in the 30's), blackouts and GI complaints were the most common neurovegetative symptoms and anxiety, depression and psychosis were the common psychiatric symptoms. 5. A significantly increased incidence of slow waves and paroxysmal sharp wave or spike abnormalities was found in the positive spike group compared to the EEG comparison qroup without organic brain disease. In the patients with positive spikes both types of abnormality remainedrelatively constant with age, but in the comparison groups these abnormalities generally increased with age. 6. Arguments for the clinical significance of positive spikes in the adult were presented, and sufficient evidence in favor of its significance exists to warrant further attention to this waveform.