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

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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

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

FOLDs (double banana).png

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

WHAM (average) 1.png