By: Mohibullah Fazli kakar

• Sharp transients of sawtooth shape (biphasic or triphasic)

occurring over the occipital region of waking subjects

during visual exploration (scanning complex picture),

mainly positive relative to other areas and time locked to

saccadic eye movements.

• Amplitude varies, but is generally below 50 μV. Duration

is 100–250 msec except in 1–3 years that can be up to

400 msec.

• Resemble positive occipital sharp transients of sleep

(POSTS) and visual evoked potential. Subjects with

prominent lambda waves also have prominent POSTS.

• In children, highest amplitude and sharpest component

is surface negative in the occipital region.

• Random and isolated waveforms but may be recur at

intervals of 200–500 msec.

• Visual evoked potentials occur in association with

saccadic eye movement.

• Do not occur before 1 year of age.

• Most common during the middle years of childhood. The prevalence of lambda waves between 3 and 12 years of age is about 80%.

• Lambda waves have been described as biphasic or triphasic; their predominant positive component is preceded and followed by a negative component.

• Strictly bilateral synchronous although may be asymmetrical on the two sides. Rarely present only on one side.

• Marked asymmetry indicates an abnormality on the side of lower amplitude.

• The most important precipitating factor is voluntary scanning eye movements.

• Lambda wave is attenuated by:

• Darkening room

• Staring at a blank card

• Eye closure

• Lambda waves usually occur as random and isolated

waveforms but may recur at intervals of 200–500 msec.

• Accompanied by eye movement and eye blink artifacts.

• Sometimes, especially when present unilaterally, they

may be mistaken for focal abnormalities, but the

distinction can be made by replacing the geometric

image with a blank surface.

• Marked and persistent asymmetry indicates an

abnormality on the side of lower amplitude.

• Lambda waves are “sharp transients occurring over the

occipital region of the head of waking subjects during visual

exploration, mainly positive

• relative to other areas and time locked to saccadic eye

movement. Amplitude varies, but is generally below 50 μV.”6

Lambda waves do not occur before 1 year of age and are

• most common during the middle years of childhood. The

prevalence of lambda waves between 3 and 12 years is about

80%. Lambda waves have been described as biphasic or

• Triphasic; their predominant positive component is preceded

and followed by a negative component. They may be

asymmetrical on the two sides or may be present only on one

• side. Strictly speaking, they are bilaterally synchronous. The

most important precipitating factor of lambda waves is voluntary

scanning eye movements. Lambda waves usually

• occur as random and isolated waveforms but may recur at

intervals of 200–500 msec as in this EEG page.9 Sometimes,

especially when present unilaterally, they may be mistaken

• for focal abnormalities, but the distinction can be made by

replacing the geometric image with a blank surface

• Lambda waves (open arrow) are “sharp transients occurring over the occipital region of the head of waking subjects

• during visual exploration,” mainly positive relative to other areas and time locked to saccadic eye movement. Amplitude varies, but is generally below 50 μV.6 Lambda waves have

• been described as biphasic or triphasic; their predominant positive component is preceded and followed by a negative component. They are most commonly seen in children

• aged 2–15 years. They may be asymmetrical, appearing bilaterally, or may be present only on one side. Strictly speaking, they are bilaterally synchronous. The most important

• precipitating factor of lambda waves is voluntary scanning eye movements.9 Note alpha rhythm with eye closure (double arrows)

• Lambda waves (A) are “sharp transients occurring over the

occipital region of the head of waking subjects during visual

exploration,” mainly

• positive relative to other areas and time locked to saccadic

eye movement. Amplitude varies, but is generally below 50

μV.6 Lambda waves have been described as biphasic or

• triphasic; their predominant positive component is preceded

and followed by a negative component. They are most

commonly seen in children aged 2–15 years. They may

• be asymmetrical on the two sides or may be present only

on one side although are strictly bilateral synchronous.

The most important precipitating factor of lambda waves

is

• voluntary scanning eye movements.9 POSTS (B, sample

from the other EEG), also known as “lambdoid waves”

are usually monophasic, sharply contoured

electropositive waves

• seen mainly during light to moderate levels of sleep.