Epilepsy may reflect a focal abnormality of cerebral tissue, but the generation of seizures typically involves propagation of abnormal activity through cerebral networks. We examined epileptiform discharges (spikes) with dense array electroencephalography (dEEG) in five patients to search for the possible engagement of pathological networks. Source analysis was conducted with individual electrical head models for each patient, including sensor position measurement for registration with MRI with geodesic photogrammetry; tissue segmentation and skull conductivity modeling with an atlas skull CT warped to each patient’s MRI; cortical surface extraction and tessellation into 1 square cm equivalent dipole patches; inverse source estimation with either minimum norm or cortical surface Laplacian constraints; and spectral coherence computed among equivalent dipoles aggregated within Brodmann areas with 1 Hz resolution from 1 to 70 Hz. These analyses revealed characteristic source coherence patterns in each patient during the pre-spike, spike, and post-spike intervals. For one patient with both spikes and seizure onset localized to a single temporal lobe, we observed a cluster of apparently abnormal coherences over the involved temporal lobe. For the other patients, there were apparently characteristic coherence patterns associated with the discharges, and in some cases these appeared to reflect abnormal temporal lobe synchronization, but the coherence patterns for these patients were not easily related to an unequivocal epileptogenic zone. In contrast, simple localization of the site of onset of the spike discharge, and/or the site of onset of the seizure, with noninvasive 256 dEEG was useful in predicting the characteristic site of seizure onset for those cases that were verified by intracranial EEG and/or by surgical outcome.