Note that 6 Hz positive spikes have two subtypes described as WHAM (waking, high amplitude, anterior, male) or FOLD (female, occipital, low amplitude, drowsy). These subtypes describe themselves, really, and the important thing to remember is that WHAM are associated with epilepsy while FOLD are not. In this second example, you can see a one second run of diffuse ~5-6 Hz activity, consistent with 6 Hz positive spikes. In this first example below, you can see a one second run of diffuse ~14 Hz activity, consistent with 14 Hz positive spikes. The EEG may be the only means of an incontrovertible. In this sense, there is more than enough justification for performing an EEG after the first seizure or in patients suspected of having epilepsy. I use the EEG as an integral part of the diagnostic process. They are most often seen in young adults and adolescents, and are not associated with increased epilepsy risk. However, as with any other medical condition, they are sometimes difficult and challenging. They should be bilateral and synchronous, and are more common in the posterior quadrants when drowsy. Taking the crown for perhaps the most uninspired name of EEG findings, 14 and 6 positive spikes describe 1-2 second bursts of sharply contoured positive waveforms that come in frequencies of either 14 Hz (13-17 Hz) or 6 Hz (5-7 Hz), or an admixture of both.
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