6 Hz spike-and-wave bursts (WHAM and FOLD)

6 Hz spike-and-wave bursts (WHAM and FOLD)

Synonymes: Phantom spike and waves

• Brief bursts of low amplitude spike-and-slow wave 6Hz (5-7Hz)
• Spike often not clearly discernible: “phantom”
• Bilateral and synchronous
• Maximal at midline (posterior or anterior)
• Relaxed wakefulness and drowsiness
• Adolescents and young adults
• duration of 1-2 seconds

Two subtypes of 6 Hz spike-and-wave bursts

• WHAM: Waking, High amplitude spike (>45uV), Anterior, Male
  • Associated with epilepsy especially when high amplitude spikes, rate <5-6Hz and persists during deep sleep

• FOLD: Female, Occipital, Low amplitude spike, Drowsy
  • Not associated with epilepsy

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FOLD: low amplitude, bilateral occipital, synchronous spike and waves (double banana)

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WHAM: anterior, bilateral, high amplitude spike and wave, associated with epilepsy (average)

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