6 ve 14 Frekanslı Pozitif Diken Fenomeninin Mahiyeti ve Klinik Münasebetleri

Abstract

This clinical EEG study investigates the nature and significance of 6 and 14 Hz positive spike phenomena recorded during sleep in children aged 6 to 17. Out of 160 neuropsychiatric cases evaluated, 25 showed this specific pattern, often localized to bilateral temporal and occipital regions. These children predominantly presented with episodic behavioral disturbances (aggressiveness, impulsivity, emotional dysregulation) and autonomic symptoms (headaches, abdominal pain, nausea). The study discusses whether these spikes are genuine epileptiform discharges or distorted sleep spindles, and proposes their likely origin in thalamic or hypothalamic structures. EEG abnormalities such as posterior slowing and disrupted rhythm during wakefulness support a hypothesis of maturational delay and cortical instability. The findings suggest that the phenomenon may represent a special, non-convulsive type of epilepsy with significant psychiatric implications.

Keywords

• Positive spike phenomenon
• EEG
• pediatric epilepsy
• thalamic dysfunction

The Meaning and Clinical Correlations of the 6 and 14 Positive Spike Phenomenon

Abstract

Bu EEG çalışmasında, 6–17 yaş arası çocuklarda uykuda görülen 6 ve 14 Hz frekanslı pozitif diken fenomeninin mahiyeti ve klinik ilişkileri incelenmiştir. 160 nöropsikiyatrik vakadan 25’inde bu ritim gözlenmiştir. Dikenler genellikle bilateral temporal ve oksipital bölgelerde yer almaktadır. Bu çocuklarda epizodik davranış bozuklukları (agresivite, dürtüsellik, affektif dengesizlik) ve baş-karın ağrısı gibi otonomik belirtiler sıklıkla görülmüştür. Fenomenin epileptik deşarj mı yoksa uyku iğciklerinin bozulmuş bir formu mu olduğu tartışılmış ve orijinin talamus-hipotalamus gibi subkortikal yapılara dayandığı önerilmiştir. Uyanıklık EEG’lerinde görülen posterior yavaşlama ve dezorganize ritim bu çocuklarda maturasyon geriliği ve kortikal instabilite ihtimalini desteklemiştir. Bu bulgular fenomenin, konvulsif olmayan fakat epilepsi ile bağlantılı özel bir EEG patern olduğunu düşündürmektedir.

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