The 14 & 6-Associated Clinical Complex: A Rejected Hypothesis Revisited

Abstract

The 14 & 6 Hz positive spike phenomenon is generally considered a normal variant finding. Our experience prompted this re-evaluation, which consisted of three parts: (1) In children referred for sleep electroencephalograms (EEGs), 100 children with normal EEG and 100 with 14 & 6—the 14 & 6 correlated with behavior disorder and aggression; (2) In 75 children referred for neurological evaluation and EEG because of behavior problems, 52% had 14 & 6 (excluding those with paroxysmal EEGs); and (3) In 57 symptomatic children having prominent 14 & 6, tabulation of symptoms yielded a complex but coherent clinical picture, including disturbances of temper, mood, attention, learning, and sleep. We conclude that 14 & 6 has clinical associations and deserves study. (J Child Neurol 1987;2:117-127).

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References

Gibbs FA , Gibbs EL : Electroencephalographic evidence of thalamic and hypothalamic epilepsy . Neurology 1981;1: 136-144.

Presthus J. , Refsum A. , Skulstad A. , Ostensjo S. : Fourteen and six per second spikes: an electroencephalographic and clinical study. Acta Psychiatr Neurol Scand 1956;31:166-167.

Kellaway P. , Moore F. , Kogawa N. : The "14 & 6/second positive spike" pattern of Gibbs and Gibbs . Electroencephalogr Clin Neurophysiol 1957 ;9:165-166.

Poser CM , Ziegler DK : Clinical significance of 14 & 6 per second positive spike complexes . Neurology 1958;8:903-912.

Kellaway P. , Crowley J. , Kogawa N. : A specific electroencephalographic correlate of convulsive equivalent disorders in children. J Pediatr 1959;55:582-592.

Walter RD , Colbert EG , Koegler RR , et al: controlled study of the fourteen- and six-per-second EEG pattern . Arch Gen Psychiatry 1960;2:559-566.

Hughes JR , Gianturco D. , Stein W. : Electro-clinical correlations in the positive spike phenomenon. Electroencephalogr Clin Neurophysiol 1961;13:599-605.

Gibbs FA , Gibbs EL : Fourteen and six per second positive spikes. Electroencephalogr Clin Neurophysiol 1963;15:553-558.

Metcalf DR : Controlled studies of the incidence and significance of 6 and 14 per second positive spiking. Electroencephalogr Clin Neurophysiol 1963;15:161.

10.

Henry CE : Positive spike discharges in the EEG and behavior abnormality. In Glaser GH (ed): EEG and Behavior . New York, Basic Books, 1963, pp 314-344.

11.

Lombroso CT , Schwartz IH , Clark DM , et al: Ctenoids in healthy youths. Controlled study of 14- and 6-per-second positive spiking. Neurology 1966;16:1152-1158.

12.

Reiher J. , Klass DW : Two common EEG patterns of doubtful clinical significance. Med Clin North Am 1968;52:933-940.

13.

Eeg-Olofsson O. : The development of the electroencephalogram in normal children from the age of 1 through 15 years. Neuropadiatrie 1971;2:405-427.

14.

Gibbs EL , Gibbs FA , Hirsch W. : Rarity of 14- and 6-per-second positive spiking among mongoloids. Neurology 1964;14: 581-584.

15.

Weiner JM , Delano JG , Klass DW : An EEG study of delinquent and non-delinquent adolescents. Arch Gen Psychiatr 1966;15: 144-150.

16.

Schwartz IH , Lombroso CT : Fourteen and six per second positive spiking (ctenoids) in the electroencephalograms of primary school pupils. J Pediatr 1968;72:678-682.

17.

Hughes JR , Means ED , Stell BS : A controlled study on the behavior disorders associated with the positive spike phenomenon. Electroencephalogy Clin Neurophysiol 1965;18: 349-353.

18.

Boelhouwer C. , Henry CE , Glueck BC : Positive spiking: A double-blind control study on its significance in behavior disorders, both diagnostically and therapeutically . Am J Psychiatry 1968;125:473-481.

19.

American Psychiatric Association : Diagnostic and Statistical Manual of Mental Disorders, ed 3. Washington, DC, American Psychiatric Association, 1980.

20.

Kurland HD , Yeager CT , Arthur RJ : Psychophysiologic aspects of severe behavior disorders. Arch Gen Psychiatr 1963;8: 599-604.