Small Sharp Spikes (SSS)
- Definition and Characteristics:
- Small Sharp Spikes (SSS), also known as Benign Epileptiform Transients of Sleep (BETS), are benign EEG variants.
- Typically characterized by brief, low amplitude spikes (<50 µV) lasting less than 50 milliseconds.
- Occur predominantly in the temporal regions, frequently during drowsiness or early sleep.
- Epidemiology:
- Common in adolescents and adults but less frequent in young children.
- Seen in approximately 10-20% of normal EEG recordings.
- Not associated with an increased risk of epilepsy or other neurological disorders.
- EEG Features:
- Characteristically monophasic or diphasic sharp waveforms.
- No associated slow-wave activity following the spikes.
- Often occur sporadically and unilaterally, although bilateral occurrence can be seen independently.
- No clear focal slowing or disruption of background EEG activity.
- Differentiation from Pathological Spikes:
- SSS do not exhibit the rhythmicity or evolution typical of epileptic spikes.
- They do not propagate or generalize.
- Not associated with clinical symptoms or seizures.
- Clinical Significance:
- Considered benign and typically do not require clinical intervention.
- Important for clinicians to recognize to prevent misdiagnosis and unnecessary treatments.
- Recognition contributes to accurate interpretation and reduces patient anxiety related to misdiagnosis.
- Management and Recommendations:
- No specific treatment required.
- Patients with identified SSS should be reassured about the benign nature.