The clinical significance of small sharp spikes: A retrospective study of 909 patients in epilepsy monitoring unit

•The sensitivity of small sharp spikes (SSS) for epilepsy was 18.6 % and the specificity was 97.5 %.•The incidence of SSS was strongly correlated with the frequency of interictal epileptiform discharges (IEDs).•SSS are closely co-lateralized with IEDs in patients with temporal lobe epilepsy (TLE).•SSS can be epileptiform EEG markers in patients with TLE.