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Spike-and-wave is a pattern of the electroencephalogram (EEG) typically observed during epileptic seizures. A spike-and-wave discharge is a regular, symmetrical, generalized EEG pattern seen particularly during absence epilepsy , also known as ‘petit mal’ epilepsy. [ 1 ]
When an EEG shows interictal epileptiform discharges (e.g. sharp waves, spikes, spike-and-wave, etc.) it is confirmatory of epilepsy in nearly all cases (high specificity), however up to 3.5% of the general population may have epileptiform abnormalities in an EEG without ever having had a seizure (low false positive rate) [8] or with a very low ...
Not every wave is preceded by a spike. Bursts increase and decrease without clear onset and offset. Slow spike waves may occur during seizures or between seizures, or may occur in absence of any observable clinical changes. This helps distinguish LGS from the pattern of extended 3-Hz spike-wave discharges. [citation needed]
It is an abnormal interictal pattern, consisting of high amplitude and irregular waves and spikes in a background of chaotic and disorganized activity seen on electroencephalogram (EEG), and frequently encountered in infants diagnosed with infantile spasms, although it can be found in other conditions such as tuberous sclerosis.
The GAERS or Genetic Absence Epilepsy Rat from Strasbourg is a recognized animal model of absence epilepsy, a typical childhood form of epilepsy characterized by recurrent loss of contact and concomitant pattern on the electroencephalogram called "spike-and-wave" discharges.
Additionally, an EEG will indicate a characteristic pattern of waves and spikes associated with the syndrome such as generalized 4–6 Hz polyspike and slow wave discharges. These discharges may be evoked by photic stimulation (blinking lights) or hyperventilation.
Lennox-Gastaut syndrome (LGS) is a developmental and epileptic encephalopathy that consists of a triad of developmental delay, mixed seizure types and an EEG demonstrating a pattern of "slow" (<2.5 Hz) spike-wave and generalized paroxysmal fast activity. Onset is most commonly prior to age 8 years but rare cases can onset in adolescence.
Ictal EEG, preceded by regression of occipital paroxysms, is characterised by the sudden appearance of an occipital discharge that consists of fast rhythms, fast spikes or both. Ictal EEG during blindness show pseudo-periodic slow waves and spikes, which differ from those seen in ictal visual hallucinations.