Activation of wicket spikes by REM sleep.

INTRODUCTION

Wicket spikes consist of monophasic arciform waveforms seen over the temporal regions, either bilaterally or independently over the two hemispheres. They should not be misinterpreted as epileptic abnormalities. They are usually found during light NREM sleep or drowsiness. In this study, we report an activation of wicket spikes by REM sleep.

METHODS

Two patients underwent 48-hour video-EEG. Their sleep macrostructure was analyzed. The presence of wicket spikes was correlated to each specific sleep stage.

RESULTS

In one case, wicket spikes appeared exclusively during REM sleep. In another patient, although wicket spikes were present throughout all sleep stages, their frequency was much higher during REM sleep (64% during REM sleep, 22% during light NREM sleep, 14% during drowsiness).

DISCUSSION

This study highlights that wicket spikes may be present exclusively during REM sleep and that this stage of sleep can activate them. This para-physiological rhythm, when first described, was linked to drowsiness and light NREM sleep. The persistence of wicket spikes during REM sleep has been only recently described and an increase in their frequency during this sleep stage has never been previously observed.