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Chapter 9 - Approach to EEG Reading

from Part II - Interpretation

Published online by Cambridge University Press:  24 June 2021

Neville M. Jadeja
Affiliation:
University of Massachusetts Medical School
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Summary

Confirm the patient’s identity, age, state(s) of recording, and the presence of any skull defects. Confirm the technical parameters of including the filter settings, sensitivity, paper speed, and time base. Note the montage you are reading in and the calibration signal. Identify the background from the foreground. Describe the background based on symmetry, continuity, voltage, organization, variability-reactivity, and sleep architecture. Categorize the foreground components as cerebral activity or artifact. Describe cerebral activity based on its location (general or lateral), occurrence (sporadic or repetitive), and morphology (slow or sharp). Then categorize the activity as normal (normal variant) or abnormal. Decide if the abnormality is epileptogenic (associated with seizures) or ictal (ongoing seizure). Evolution is the hallmark of electrographic seizure activity. Remember that isolated changes in amplitude are not evolution. Look for the use of any provocation methods, such as hyperventilation and photic stimulation, and their effect on the EEG. Before you finish up, make sure you’ve looked at the single-channel EKG and the technologist’s log.

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Chapter
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How to Read an EEG , pp. 61 - 66
Publisher: Cambridge University Press
Print publication year: 2021

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References

Cobb, WA, Guiloff, RJ, Cast, J. Breach rhythm: the EEG related to skull defects. Electroencephalography and Clinical Neurophysiology. 1979 Sep 1;47(3):251–71.CrossRefGoogle ScholarPubMed
Otsubo, H, Steinlin, M, Hwang, PA, et al. Positive epileptiform discharges in children with neuronal migration disorders. Pediatric Neurology. 1997 Jan 1;16(1):2331.Google Scholar
Museum of Fine Arts, Boston.Google Scholar
Hirsch, LJ, LaRoche, SM, Gaspard, N, et al. American clinical neurophysiology society’s standardized critical care EEG terminology: 2012 version. Journal of Clinical Neurophysiology. 2013;30(1):127.CrossRefGoogle ScholarPubMed
American Electroencephalographic Society Ad Hoc Guidelines Committee. Minimum technical requirements for performing clinical electroencephalography. Journal of Clinical Neurophysiology. 1994;11:25.CrossRefGoogle Scholar

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