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Unit 14 Week 4 (Tommy) > "A Clinician's Guide to EEG" > Flashcards

"A Clinician's Guide to EEG" Flashcards

1
Q

What does EEG stand for?

A

Electroencephalogram (EEG)

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2
Q

Explain the electrode placement in EEG

A
  • Capital Letter - reflects brain lobe/region
    • ​F = Frontal
    • T = Temporal
    • P = Parietal
    • O = Occipital
    • C = Central
  • Number or lower case letters denote position:
    • Odd – left
    • Even - right
    • p - fronto-polar
    • z – midline

Cz important electrode

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3
Q

Explain what happens in an EEG

A
  • Pain free
  • Non-invasive
  • ~20-30mins
  • Electrodes onto different areas of the head
    • Electrodes connected to an amplifyer
      • Amplifier connected to a computer
        • Physiologist interprets computer
  • EEG records somated electrical activity (made by many neurons) from cortex
    • Records in ccolumns
    • 1 electrode sits over ~400 functional columns
  • Hard for EEG pick up exact electrical activity due to background noise, skull (in the way), background noise
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4
Q

Explain differential amplifiers in EEG

A
  • Magnifies the voltage input (easier to interpret)
  • Subtracts the common components in signals between two inputs and amplifies this.
  • Useful in biological systems
  • Can detect small differences between two inputs
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5
Q

Explain the montage in EEG & types

A

Subtract from each other calculating differential amplifiers & describes the direction of the electrodes and way of calculation of differential amplifications

2 types:

  1. Longitudinal (LEFT)
    • ​​Good at looking at temporal lobes
  2. Transverse (RIGHT)
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6
Q

Explain this EEG

A

Green lines = time measurement

Red lines = records when a change is made e.g. eyes open/eyes closes/sneeze/hyperventilation (make patient blow paper windmill)

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7
Q

How to work out differential amplifications?

A
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8
Q

What needs to be done when interpretting EEGs?

A
  • Age of patient (different waves in different aged individuals)
  • Clinical state of patient e.g. awake, drowsy, asleep
  • Montage
  • Wave forms
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9
Q

Explain the types of wave formations in EEG

A
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10
Q

If … waves appear on an EEG, one should be worried

A

Delta waves

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11
Q

What is the typical story when somene has a seizure?

A
  • Collapsed without warning
  • Witnessed to become stiff, and then started jerking. Foaming at mouth, and became cyanosed. Breathing pattern changed Incontinent of urine (INCREASE motor activity)
  • Lasted 2 minutes
  • Recovered slowly over 30 minutes, and was confused afterwards
  • Headache, tongue biting
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12
Q

How to assess someone who has had a seizure?

A

LEARN soring system in picturee

  • Risk classification will determine if someone gets treated
  • EEG NOT used for diagnosis
    • Looks at risk of seizure happening again
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13
Q

What to look for on an EEG when looking for epileptic activity?

A
  • Typically looking for inter-ictal epileptiformdischarges (IEDs): asymptomatic epileptic abnormalities occurring between seizures
  • Ictal = epileptic discharge producing clinical seizure
  • Spikes or sharp waves, superimposed on background rhythms
  • Localised versus generalised patterns : essential role in classifying the type of seizure disorder.
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14
Q

Types of waves in epileptic activity

A
  • Sharp waves
  • Spikes = short in guration
  • Spikee & wave
  • Polyspike
  • Polyspike & wave
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15
Q

What independant variables would you introduce in order to see epileptic activity on an EEG?

A
  • Hyperventilation (good test in childhood - blow windmill)
  • Photic stimulation
  • Sleep deprivation
    • ​30% patients able to see epileptic activity thanks to this (easier diagnosis)
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16
Q

When would you start treatment for epilepsy & when would you give it?

A

After 2 events give anti-convusant treatment

17
Q

What are the seizure classifications? & explain them

A
  1. Focal onset (LEFT)
    • Doesn’t start bilaterally
      • Involes _uni_lateral networks (can spread and engage bilateral networks
  2. Generalised onset (RIGHT)
    • ​​Seizure originating with BIlaterally distributed networks
    • Types:
      • Absence
        • ​S**udden ON & OFF onset
      • Myoclonic
        • Brief jerk movements especially in upper limbs
      • Atonic
        • Loses ALL postural control (falls to ground)
      • Clonic
        • Sustained rhythmical jerking
      • Clonic-tonic
        • Stiffness onset followed by jerking
  3. Unknown onset
18
Q

What kind of seizure is this?

A

Ictal-EEG

19
Q

What kind of seizure is this?

A

Inter-ictal EEG (as separate)

20
Q

What kind of differential amplitudes would this give?

A
21
Q

What is this seizure?

A

Continuous seizure activity

22
Q

What is status epilepticus? & types

A
  • Continuous seizure activity for > 5-30+ minutes
  • 2 types:
    1. Convulsive Status Epilepticus - urgeent treatment (ICU)
      • ​​Obvious motor features
      • Clinical diagnosis – no EEG required (usually)
    2. Non-Convulsive Status Epilepticus
      • ​​No obvious motor features
      • Confusion/Altered consciousness
      • Consider in patient with epilepsy
      • EEG
23
Q

What is videotelemetry?

A
  • Patient continuously monitored ~2 weeks with EEG & video recording
  • Used for diagnosing difficult seizures (UNKNOWN ones)
    • & understand where they arise from
  • Common in focal epilepsy to locate and then do surgery
24
Q

What is advanced EEG (electrocorticography)?

A
  • NO scalp/skull blocking signals
  • Done so during surgery minimal amount of tissue is removed
    • Understand WHERE seizure is starting
    • Able to stimulate are they think is affected
  • Is a grid of electrodes that is placed DIRECTLY over the cortex in order to monitor which areas are affected
25
Q

What is a dissociation seizure?

A
  • Many seizures everyday ~20 a day
    • Start and stop (& recover rapidly)
26
Q

What is Prion Disease & explain it

A
  • Group of rare, uniformly fatal neurodegenerative diseases
  • Sporadic (85-90%); Genetic (10-15%) and acquired (<1%)
  • Symptoms include: difficulty walking (with falls), confusion, poor memory, ataxia, myoclonic jerks
  • Good see on EEG = TRIphasic complexes
27
Q

What is narcolepsy?

A
  • Tetrad (symptoms)
    • Daytime sleepiness
    • Cataplexy (sudden, brief loss of voluntary muscle tone triggered by strong emotions such as laughter)
    • Sleep paralysis
    • Hypnagogic/hypnopompic hallucinations
  • Multiple Sleep Latency Test (MSLT) - can do after treatment (see if medication has worked)
    • 5 separate EEG recordings
    • Dark, quiet room
    • Sleep latency usually 10-20mins
    • Abnormal mean latency <8mins –> will be in REM sleep very fast
    • SOREMP on minimum 2 occasions (need 2 readings)

Unit 14 Week 4 (Tommy) (5 decks)

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