Skip to main content Accessibility help
×
Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-19T03:01:41.400Z Has data issue: false hasContentIssue false

4 - How Can I Best Use EEG for Treating Epilepsy Patients?

Published online by Cambridge University Press:  28 January 2023

Patrick Landazuri
Affiliation:
University of Kansas Medical Centre
Nuria Lacuey Lecumberri
Affiliation:
University of Texas Health Science Center, Houston
Laura Vilella Bertran
Affiliation:
University of Texas Health Science Center, Houston
Mark Farrenburg
Affiliation:
University of Kansas Medical Centre
Samden Lhatoo
Affiliation:
University of Texas Health Science Center, Houston
Get access

Summary

An electroencephalogram (EEG) is a critical tool in epilepsy diagnosis. The three common EEG durations are 25 minutes, 1 hour, and 24 hours. One-hour EEGs are superior in showing epileptiform abnormalities, while 24-hour EEGs are used to characterize seizure and nonepileptic event semiology and guide treatment of status epilepticus. The term EEG montage refers to the way EEG electrodes are ordered for interpretation. Odd numbered electrodes are on the left, with even numbered on the right. Smaller numbers are closer to the midline, while z means the electrode is on the midline.This chapter will explore the numerous normal and variant findings like posterior dominant rhythm (PDR) and wicket spikes. Epileptiform findings like sharp waves or seizure patterns are indicative of epilepsy. Slowing or increased amplitude can indicate cerebral changes that are not epileptiform.Electroencephalogram reports should concisely accurately convey both the electrical findings and their clinical relevance to patient care. Electroencephalogram reports should indicate an epilepsy diagnosis only when clear electrical evidence exists.

Type
Chapter
Information
Seizure and Epilepsy Care
The Pocket Epileptologist
, pp. 57 - 78
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Works Cited

Burkholder, DB, Britton, JW, Rajasekaran, V et al. Routine vs extended outpatient EEG for the detection of interictal epileptiform discharges. Neurology. 2016;86(16):1524–30.Google Scholar
Salinsky, M, Kanter, R, and Dasheiff, RM. Effectiveness of multiple EEGs in supporting the diagnosis of epilepsy: An operational curve. Epilepsia. 1987;28(4):331–4.CrossRefGoogle ScholarPubMed
Marsan, CA and Zivin, LS. Factors related to the occurrence of typical paroxysmal abnormalities in the EEG records of epileptic patients. Epilepsia. 1970;11(4):361–81.Google Scholar
King, MA, Newton, MR, Jackson, GD et al. Epileptology of the first-seizure presentation: A clinical, electroencephalographic, and magnetic resonance imaging study of 300 consecutive patients. Lancet. 1998;352(9133):1007–11.Google Scholar
Daube, JR and Rubin, DI. Clinical Neurophysiology. 3rd ed. New York: Oxford University Press; 2009. xxvii.Google Scholar
Nayak, CS and Anilkumar, AC. EEG Normal Waveforms. Treasure Island, FL: StatPearls; 2021.Google Scholar
Rey, V, Aybek, S, Maeder-Ingvar, M, and Rossetti, AO. Positive occipital sharp transients of sleep (POSTS): A reappraisal. Clin Neurophysiol. 2009;120(3):472–5.CrossRefGoogle ScholarPubMed
Lüders, H and Noachtar, S. Atlas and Classification of Electroencephalography. Philadelphia: Saunders; 2000. xiv.Google Scholar
Salvioni Chiabotti, P, Vicino, A, and Rossetti, AO. Lateralized rhythmic delta activity: A peri-ictal feature beyond epilepsy. Clin Neurophysiol. 2021;132(6):1302–3.CrossRefGoogle ScholarPubMed
Shorvon, S, Guerrini, R, Cook, M, and Lhatoo, S. Oxford Textbook of Epilepsy and Epileptic Seizures. Oxford: Oxford University Press; 2013.Google Scholar
Hirsch, LJ, Fong, MWK, Leitinger, M et al. American Clinical Neurophysiology Society’s standardized critical care EEG terminology: 2021 version. J Clin Neurophysiol. 2021;38(1):129.CrossRefGoogle ScholarPubMed
Foldvary, N, Klem, G, Hammel, J et al. The localizing value of ictal EEG in focal epilepsy. Neurology. 2001;57(11):2022–8.Google Scholar
Javidan, M. Electroencephalography in mesial temporal lobe epilepsy: A review. Epilepsy Res Treat. 2012;2012:637430.Google ScholarPubMed
Lee, SK, Lee, SY, Kim, KK et al. Surgical outcome and prognostic factors of cryptogenic neocortical epilepsy. Ann Neurol. 2005;58(4):525–32.CrossRefGoogle ScholarPubMed
Murakami, S and Okada, Y. Contributions of principal neocortical neurons to magnetoencephalography and electroencephalography signals. J Physiol. 2006;575(pt. 3):925–36.CrossRefGoogle ScholarPubMed
Stefan, H, Hummel, C, Scheler, G et al. Magnetic brain source imaging of focal epileptic activity: A synopsis of 455 cases. Brain. 2003;126(pt. 11):2396–405.CrossRefGoogle ScholarPubMed
Malmivuo, J, Suihko, V, and Eskola, H. Sensitivity distributions of EEG and MEG measurements. IEEE Trans Biomed Eng. 1997;44(3):196208.CrossRefGoogle ScholarPubMed
St. Louis, EK and Frey, LC. Electroencephalography: An Introductory Text and Atlas of Normal and Abnormal Findings in Adults, Children, and Infants. Chicago: American Epilepsy Society; 2016. www.ncbi.nlm.nih.gov/books/NBK390354/pdf/Bookshelf_NBK390354.pdf.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×