Vertex Sharp Wave Transients

Posted on
May 26, 2023
Let's learn all the facts about a brain pattern called

Vertex Sharp Wave Transients

Go BackJump To Question

EEG Sample Credit: The Learning EEG (

Vertex Sharp Wave Transients (V Waves)

V waves can be recognized in infants at as early as 2 months of age. Low-voltage theta with POSTS, low-voltage V waves, and drifting horizontal eye movements with decreased muscle artifact denote N1 sleep. V waves first appear as a sign of late drowsiness in N1 sleep with a lower amplitude and are less sharply contoured as compared to that seen in N2. V waves should be easily distinguishable from the background.  

They are bilateral phase reversing discharges over the central regions maximal at CZ and the central derivations. V waves usually have a maximal amplitude (on referential montages) and reverse phase (on bipolar montages) at the CZ electrode.  The spread may involve the neighboring central (C3, C4) and sometimes frontal electrodes. 

V waves are diphasic, sharply contoured, surface-negative waves followed by a small positive phase lasting 70-200ms, with highly variable amplitude that are generally symmetrical and synchronous These waves appear singly in adults or in serial repetitive runs especially in young children and may be quite sharp or high amplitude. In adults, the amplitude is usually 100 to 150μV, and in children up to 250μV. Although they are scary looking they are normal and rarely considered epileptiform. A V wave is primarily a spontaneous phenomenon but they can be elicited by a light arousal stimulus.

Of the following montages, which is the most beneficial for recording sleep architecture on the EEG such as Vertex sharp waves and K complexes?
AP Bipolar
Circumferential (Hatband)
Transverse Bipolar
CZ Reference
Correct Answer: 

Since a transverse montage runs sequentially from the left temporal, left parasagittal, midline, right parasagittal, and right temporal, it is useful to determine if a given activity has temporal or parasagittal dominance, but it is less useful to determine the potential gradient in the anterior–posterior direction. The transverse montage is especially useful in sleep recordings as it reveals better defined vertex sharp-wave phase reversals at the midline electrodes. The K complex also shows a phase reversal at the midline, but with more frontal dominance.


The Learning EEG (

Yamada, Thoru, and Elizabeth Meng. Practical Guide for Clinical Neurophysiologic Testing: EEG. Available from: Wolters Kluwer, (2nd Edition). Wolters Kluwer Health, 2017.

Greenfield, John, L. et al. Reading EEGs: A Practical Approach. Available from: Wolters Kluwer, (2nd Edition). Wolters Kluwer Health, 2020.

Go Back To All EEG Fun Facts