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©2013 UpToDate ® Print Email Benign EEG variants Patient: age / state Waveform: morphology / frequency Duration Distribution Benign spike-like patterns Small sharp spikes Adults / drowsiness and light sleep Monophasic or diphasic spikes Phase <50 msecs Bi-hemispheric maximal-anterior / mid temporal Wicket spikes Adults / drowsiness and light sleep Sharply contoured arch shaped / 6 to 11 Hz Few seconds Bilateral anterior / mid temporal 14- and 6-Hz positive bursts Children and adolescents / drowsiness and light sleep Arch shaped positive sharp component / 4-7 Hz and 13-17 Hz range Less than 1 to 2 seconds Bilateral posterior temporal / parietal 6 Hz spike and wave Adolescents and young adults / relaxed wakefulness and drowsiness Low voltage spike-high amplitude slow wave / 5 to 7 Hz 1 to 2 seconds Generalized / at times maximal anterior or posterior Rhythmic patterns with an epileptiform morphology Rhythmic temporal theta bursts of drowsiness Adolescents and young adults / relaxed wakefulness and drowsiness Notched flat topped / 5 to 7 Hz Seconds Bilateral temporal Subclinical rhythmic EEG discharge in adults Adults >50 / hyperventilation, drowsiness Rhythmic sharply contoured / 5 to 6 Hz 40 to 80 seconds Bilateral parietal / posterior temporal Midline theta rhythm Children and adults / awake, drowsy Sinusoidal, arciform / 5 to 7 Hz 4 to 20 seconds Midline, maximal centrally Reproduced with permission from: Mushtaq, R, Van Cott, AC, Benign EEG variants. Am J Electroneurodiagnostic Technol 2005; 45:88. Copyright ©2005 American Society of Electroneurodiagnostic Technologists.