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Dr Bray's comments are well taken but his queries are, in fact, already answered in the "Comment" section of our report. One point that we would like to make is that midtemporal Sylvian spikes can be seen in 1.5% to 2% of normal children, but the EEGs with multifocal spikes and spike and slow wave complexes seen in our patients with Sydenham's chorea were quite different. These abnormalities were never described in normal controls. They were seen in five of 28 (more than 18%) of our patients and were much too excessive and much too frequent to be expected in any normal population. The original EEG tracings were reviewed by at least four qualified electroencephalographers, who all agreed that the epileptiform electrical discharges were indeed abnormal.The main purpose of our report was to bring to attention a possible relationship between seizures, be they clinical or electrical, and Sydenham's chorea.
Ch'ien LT, Economides AN, Lemmi H. Sydenham's Chorea and Epileptic Seizures-Reply. Arch Neurol. 1979;36(6):388. doi:10.1001/archneur.1979.00500420098023