14- and 6-Hz positive bursts and N waves: Lesser known benign EEG variants in adolescents
Bibliographic record
Abstract
A 9-year old, right-handed, developmentally normal boy presented with frequent brief paroxysmal events for the last 6 months. These happened only while sleeping and were characterized by multifocal jerking of bilateral arms and legs independently. In the past, he had experienced one generalized tonic–clonic seizure while sleeping 2 years ago. His magnetic resonance imaging of the brain was normal. His previous two routine electroencephalograms (EEGs) were normal. A prolonged video-EEG was requested to characterize the ongoing events. This EEG diagnosed these events to be sleep myoclonus. It did not show any interictal epileptiform abnormalities but showed interesting benign EEG variants: 14- and 6-Hz positive bursts and “N” waves [Figure 1].Figure 1: EEG epochs from the EEG of the reported patient. (a and b) show typical 14- and 6-Hz positive bursts and N waves' morphology in bipolar (a) and referential (Pz) montages (b). N-shaped wave configuration is formed by the apposition of 14- and 6-Hz positive bursts and sleep features like vertex waves. The morphology may resemble a spike wave discharge (c). (d) shows a more complex morphology of the N wave. These discharges were seen in drowsiness, N1, and REM sleep statesFourteen- and 6-Hz positive bursts are predominantly seen during drowsiness, light and rapid eye movement (REM) sleep, and have maximal amplitude over the posterior temporal head region.[1] They have been shown to be of hippocampal origin on simultaneous stereotactic EEG and scalp EEG recordings.[2] Blume et al.,[3] described “N” waves as a normal variant occurring in association with 14- and 6-Hz positive bursts. This EEG feature can sometimes be mistakenly reported as epileptiform. However, the typical 14- and 6-Hz morphology preceding the complex and its disappearance during deeper sleep stages might differentiate N waves from the epileptiform abnormalities. However, Oletsky et al.,[4] reported 14- and 6-Hz positive bursts to be consistently preceding the generalized paroxysms in an adolescent girl with childhood absence epilepsy. Thus, the morphology of N waves should be kept in mind and both under- and overreporting of EEGs should be avoided. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".