Intro to EEG Nicholas J. Beimer, MD. Lead placement 10-20 system.

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Presentation transcript:

Intro to EEG Nicholas J. Beimer, MD

Lead placement system

Common montages longitudinal bipolar transverse

Normal 20 year old

Frequency ranges of EEG HzDelta 4-8 HzTheta 8-12 HzAlpha >13 HzBeta * Difference between alpha frequency and alpha rhythm

Normal 20 year old 10 Hz PDR (posterior dominant rhythm)

Normal PDR by age 3-4 Hz3-4 months 5-6 Hz1 year 7 Hz2 years 8 Hz3 years 8.5 Hz8-10 years

Normal

Eye closure

Normal

Alpha squeak: transient increase in alpha rhythm after eye blink

Normal

Lambda waves: sharply contoured, occipital, occur with visual scanning

Normal

POSTS: positive occipital sharp transients of sleep

Normal

Sleep spindles: about 13 Hz, 0.5 sec burst, characteristic of stage II sleep

Normal

K complex: Negative sharp wave, then slower positive component, associated with spindles

Normal

Vertex waves

Normal

Posterior slow waves of youth (prominent in ages 3-10)

If this is normal, how old is the patient?

Normal 75 year old Age >65: Focal temporal delta slowing once every several minutes Increase in frontal beta PDR still 8.5 hz or greater

Normal

Hypnagogic hypersynchrony: 4-5 Hz rhythmic bursts in young children, a marker of drowsiness and transitional sleep

Normal Rapid lateral eye movements

Normal Sawtooth waves: theta frequency, sawtooth shape

REM

Provocative measures

Photic driving

Provocative measures Photic driving

Provocative measures Slowing with hyperventilation

Benign variants

Mu: frontocentral alpha rhythm that disappears when pt. opens and closes contralateral hand

Benign variants

RMTTD: rhythmic temporal theta of drowsiness

Benign variants

BETS: benign epileptiform transients of sleep

Benign variants

Wicket spikes

Benign variants 14 and 6 positive bursts 14 and/or 6 Hz 6 Hz more common in early childhood 14 Hz more common in late childhood/adolescence

Benign variants 14 and 6 positive bursts 14 and/or 6 Hz 6 Hz more common in early childhood 14 Hz more common in late childhood/adolescence