Drury I
Department of Neurology, University of Michigan Medical School, Ann Arbor.
Electroencephalogr Clin Neurophysiol. 1989 Jun;72(6):479-85. doi: 10.1016/0013-4694(89)90224-1.
14-and-6 Hz positive bursts, a benign epileptiform variant, have also been described in comatose children with liver disease, chiefly Reyes syndrome. To determine the incidence of this pattern in children in stupor or coma, 154 portable EEGs in 111 children with mental status changes were reviewed. Seven children showed 14-and-6 Hz bursts in the setting of moderate to marked background slowing. They were similar to positive bursts seen in normals in location, duration, morphology, frequency and repetition rate. They differed in being readily activated by stimulation. The etiology was toxic/metabolic in 4 cases, primary cerebral insult in 2 cases and a combination of the two in 1 case. Amongst an age-matched control population, 5 of 75 showed 14-and-6 Hz positive bursts in stage I or II sleep. There were no statistically significant differences in incidence rates between the 2 groups. 14-and-6 Hz positive bursts may occur in diverse encephalopathies of childhood, not just Reyes syndrome. The similar incidence rate, morphology and topography to normals suggest that the presence of these wave forms in encephalopathies represents persistence of a normal EEG feature rather than an expression of some underlying pathophysiological process.
14和6赫兹正相暴发，一种良性癫痫样变异型，也在患有肝病的昏迷儿童中有所描述，主要是瑞氏综合征。为了确定这种脑电图模式在昏迷或昏睡儿童中的发生率，对111名精神状态改变儿童的154份便携式脑电图进行了回顾性分析。7名儿童在中度至显著的背景慢波情况下出现了14和6赫兹暴发。它们在位置、持续时间、形态、频率和重复率方面与正常人所见的正相暴发相似。它们的不同之处在于容易被刺激激活。病因方面，4例为中毒/代谢性，2例为原发性脑损伤，1例为两者合并。在年龄匹配的对照组中，75名中有5名在I期或II期睡眠时出现14和6赫兹正相暴发。两组之间的发生率没有统计学上的显著差异。14和6赫兹正相暴发可能发生在儿童的多种脑病中，而不仅仅是瑞氏综合征。其与正常人相似的发生率、形态和分布表明，这些波形在脑病中的出现代表了正常脑电图特征的持续存在，而非某种潜在病理生理过程的表现。
