EEG Sample: The Learning EEG (learningeeg.com)
These 1-2 second bursts of paroxysmal arciform or sharp appearing positive waveforms can occur in the frequency ranges of either 14Hz or 6Hz. They may also be a mix of both frequencies. 14Hz & 6Hz Positive Spikes should be bilateral and synchronous. This pattern is seen in the posterior quadrants during relaxed wakefulness, drowsiness, or in the early stages of sleep. 14Hz & 6 Hz appear in young adults and adolescents with no increased risk of epilepsy. The 6Hz spike-and-wave bursts also known as Phantom spike and waves are brief bursts of low amplitude spike-and-slow waves in the 6Hz (5-7Hz) range. The spikes in these waveforms are often not seen and referred to as “phantoms”. They are maximal at the midline and can be either posterior or anterior dominant.
Question:
What are the two subtypes of the 6Hz spike-and-wave bursts?
Results
#1. What are the two subtypes of the 6Hz spike-and-wave bursts?
WHAM: (waking, high amplitude spike (>45uV), anterior, male)- more commonly recorded during wakefulness, of higher amplitude, with more frontal topography, and observed in males. This particular subtype is associated with epilepsy, especially when high amplitude spikes at a rate of <5-6Hz persist during deep sleep.
FOLD; (female, occipital, low amplitude, drowsy) – observed more often in females, of more occipital topography, of lower amplitude, and more commonly recorded during drowsiness. This rare and benign EEG finding should not be mistaken for epileptiform discharges
These subtypes describe themselves. The key thing to remember is that WHAM is associated with epilepsy while FOLD is not.
