EEG Basics

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EEG basic information
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Alpha 8-13 Hz Occipital distribution Attenuates with Eye opening Alpha Squeak
Beta 14-30 Hz Frontal distribution More prominent in drowsiness/light sleep
Theta 4-8 Hz diffuse distribution or bitemporal regions increase in drowsiness
Delta >4 hz Variable distribution Normal in deep sleep, abnormal during wakefulness
Mu 8-10 Hz Central distribution attenuates with contralateral extremity movement
What are the EEG characteristics are present in stage I sleep/drowsiness? slow rolling eye movements, V-waves, attenuation of alpha, central/frontocentral theta, enhanced beta, POSTS, hypnagogic hypersynchrony
When are V waves first seen? as early as 2 months of age
What EEG characteristics are present in stage II sleep? Sleep spindles, K complexes, V waves, attenuation of alpha, central/frontocentral theta, enhanced Beta, POSTS, Hypnagogic Hypersynchrony, Delta
What EEG characteristics are present in stage III sleep? Mostly delta, with sleep spindles and K complexes
What EEG characteristics are present in REM sleep? Low amplitude, mixed frequency, Rapid eye movements, saw tooth waves, EEG desynchronization
What are the most prominent physiological artifacts which may be present on the EEG? EMG (muscle) ECG Sweat sway
What are the most prominent non-physiological artifacts which may be present on EEG? 60 Hz/ alternating current electrode artifact
Describe Bell's Phenomenon the eye acts as a dipole with cornea as positive pole and retina negative pole. This causes artifact with eye movements- looking upwards or closing eyes causes a positive EEG deflection, and looking downwards/closing eyes causes a negative deflection
What is Epilepsy? a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures and by the neurobiologic, cognitive, psychological, and social consequences of this condition.
What are interictal Epileptiform discharges? Distinctive waves or complexes which are distinguished from the background and which resemble similar patterns that have been recorded in subjects with epilepsy
What are the 4 morphologies of interictal discharges? Sharp waves, spikes, polyspikes, sharp and slow wave or spike and slow wave complex
What are the four categories of electrographic response to photic stimulation? Visual evoked response, photic driving, Photomyogenic response, photoparoxysmal response
What are the contraindications for hyperventilation? acute stroke, recent intracranial hemorrhage, large vessel stenosis, documented moya moya disease, cardiopulmonary disease, sickle cell disease
What are normal responses to hyperventilation? no change OR symmetrical slow activity/ FIRDA / OIRDA
Why is it important to ask time of last meal? Because hyperglycemia can cause a marked response to HV
Which epilepsy syndromes commonly show activation with sleep? benign occipital epilepsy in infancy, Lennox-Gastaut syndrome, benign epileptiform central/midtemporal spikes, juvenile myoclonic epilepsy, frontal lobe epilepsy, Landau-Kleffner
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