Occasionally, ones sees occipital positive sharp slow waves in the record of a patient who is lying quietly in bed awake. These waves may be quite asymmetric and raise the possibility
of a focal abnormality. The normal lambda wave is identified by doing a few simple maneuvers. The wave is felt to represent occipital lobe activity in a person who is actively reading or scanning the room. Often the subjects have their eyes open and are looking carefully at the ceiling tiles. The technician will have the patient reproduce the maneuver that they felt caused the waves to appear in the first place. They will then have the patient close their eyes, which will block the normal lambda wave but usually not have an effect on the abnormal activity. They will then have them open their eyes and look at a plain piece of paper, which also blocks the normal lambda wave but will not effect the epileptiform discharges, which are most often mistaken for a lambda wave (3).
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