A case–control study of wicket spikes using video-EEG monitoring

PURPOSE To investigate clinical characteristics associated with wicket spikes in patients undergoing long-term video-EEG monitoring. METHODS A case-control study was performed in 479 patients undergoing video-EEG monitoring, with 3 age- (±3 years) and gender-matched controls per patient with wicket spikes. Logistic regression was utilized to investigate the association between wicket spikes and other factors, including conditions that have been previously associated with wicket spikes. RESULTS Wicket spikes were recorded in 48 patients. There was a significantly higher prevalence of dizziness/vertigo (p=0.002), headaches (p=0.005), migraine (p=0.015), and seizures (p=0.016) in patients with wickets. The majority of patients with wicket spikes did not exhibit epileptiform activity on EEG; however, patients with history of seizures were more likely to have wickets (p=0.017). There was no significant difference in the prevalence of psychogenic non-epileptic seizures between the groups. Wickets were more common on the left, during sleep, and more likely to be first recorded on day 1-2 of monitoring. CONCLUSIONS Patients with wicket spikes are more likely to have dizziness/vertigo, headaches, migraine, and seizures. Patients with history of seizures are more likely to have wickets. The prevalence of psychogenic non-epileptic seizures is not significantly higher in patients with wickets.