BENIGN Variants

14 Hz Positive Spike Bursts:

• Definition: 14 Hz positive spike bursts are a type of abnormal electrical brain activity observed in
electroencephalography (EEG) recordings. These bursts consist of repetitive spikes at approximately 14
Hz with a positive polarity.

• Clinical Significance: These spike bursts are associated with specific epilepsy syndromes, such as
juvenile myoclonic epilepsy (JME). JME is characterized by sudden muscle jerks (myoclonic seizures) and
often occurs in adolescents.

6 Hz Positive Spike Bursts:

• Definition: 6 Hz positive spike bursts are another type of abnormal EEG pattern characterized by
repetitive, positive spikes at around 6 Hz. These spike bursts are not as common as other epileptiform
patterns.

• Clinical Significance: These spike bursts are associated with specific epilepsy syndromes, such as
juvenile myoclonic epilepsy (JME). JME is characterized by sudden muscle jerks (myoclonic seizures) and
often occurs in adolescents.

Small Sharp Spikes (SSS):

• Definition: Small Sharp Spikes (SSS), also known as “sharp waves,” are distinctive EEG waveforms
characterized by their short duration and high amplitude. They appear as sudden, sharp deflections in
the EEG tracing, often resembling a spike or spike-and-wave complex.

• Clinical Significance: SSS are often considered epileptiform discharges, meaning they are associated
with epilepsy or a predisposition to seizures.These discharges may be indicative of underlying
neurological abnormalities or increased susceptibility to seizures.The presence of SSS in an EEG can help
in diagnosing and classifying epilepsy syndromes.

Phantom Spike and Wave:

• Definition: is a term used in EEG interpretation to describe the presence of epileptiform spike and wave
patterns on the EEG recording when no clinical signs or symptoms of epilepsy or seizures are present. In
other words, it refers to the appearance of epileptiform discharges in the EEG that do not correlate with
observable seizures.
• Clinical Significance: Phantom Spike and Wave can pose a diagnostic challenge because the lpresence
of epileptiform activity on EEG suggests an increased risk of epilepsy. However, when no seizures or
epilepsy symptoms are observed, clinicians may question the clinical relevance of these findings.It is
crucial for healthcare professionals to carefully evaluate the patient’s history, medical condition, and
other diagnostic tests to determine the significance of Phantom Spike and Wave in the absence of clinical
seizures.

WICKET SPIKE:

• Definition: A Wicket Spike, also known as a “Wicket Rhythm” or “Wicket Activity,” is an EEG finding
characterized by a pattern resembling the shape of a cricket wicket, which consists of three or more
spikes or sharp waves followed by slow-wave components. It is considered an abnormal waveform.

• Clinical Significance:Wicket Spikes are considered an abnormal EEG finding and may indicate
underlying neurological abnormalities.They can be associated with conditions such as epilepsy,
particularly in individuals with complex partial seizures.

RMTD:

• Definition: Rhythmic Midtemporal Theta of Drowsiness (RMTD) is an abnormal EEG pattern

characterized by rhythmic and repetitive theta wave activity, particularly localized to the midtemporal
regions of the brain. It occurs during the transition from wakefulness to a drowsy or relaxed state, often
as an individual starts to fall asleep.

• Clinical Significance:RMTD is generally considered a benign EEG pattern, often observed in healthy
individuals during relaxation or as they begin to drift into light sleep.It is not typically associated with
pathological conditions or epilepsy.