Positive occipital sharp transients of sleep (POSTS): a reappraisal.
OBJECTIVE
Positive occipital sharp transients of sleep (POSTS) are considered a normal variant seen in non-REM sleep; their asymmetrical presentation and relationship with EEG abnormalities have received scarce attention to date. We analyzed these features in a large prospective EEG recordings' sample.


METHODS
In this case-control study, over 6 months we collected consecutive patients showing POSTS on their EEG. They were matched with consecutive control subjects (two for each). Demographical data, asymmetries for POSTS and alpha activity, and lateralized or diffuse occurrence of EEG abnormalities (slowing, epileptiform transients) were compared among these two groups.


RESULTS
Out of 1254 EEG studies, 102 (8%) patients showed POSTS. They were younger (p=0.031), and more likely to show EEG abnormalities (p=0.008) - including epileptiform transients (p=0.002) - than controls. However, this relationship was influenced by age and recording length. Thirty nine POSTS recordings (38%) had a consistent amplitude asymmetry, but this was not associated with specific EEG abnormalities or alpha asymmetry.


CONCLUSIONS
POSTS are a normal EEG variant, occurring in less than 10% of unselected EEG recordings, mostly in younger adults, without gender predominance. Amplitude asymmetries are found in over one third of subjects.


CONCLUSIONS
POSTS asymmetry, as opposed to other sleep transients, should be considered as normal.
Rey
Vincianne
V
Service de Neurologie, Centre Hospitalier Universitaire Vaudois et Université de Lausanne (CHUV-BH07), CH-1011 Lausanne, VD, Switzerland. vincianne.rey@chuv.ch
Aybek
Selma
S
Maeder-Ingvar
Malin
M
Rossetti
Andrea O
AO
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000175:diagnosis / Q000503:physiopathology; D005071:Evoked Potentials / Q000502:physiology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000502:physiology*; D011446:Prospective Studies; D012890:Sleep / Q000502:physiology*; D013997:Time Factors; D055815:Young Adult