EEG Maturation

Question 1

What are the two stages of sleep in neonates?

Answer 1

Quiet Sleep and Active Sleep

Question 2

Describe Quiet Sleep in neonates.

Answer 2

Eye closure, absent REM, muscle tone present, occasional sucking activity, regular heart rate and respirations

Question 3

What characterizes Active Sleep in neonates?

Answer 3

Eyes closed, intermittent periods of REM, irregular respirations and heart rate

Question 4

What is Trace Alternant?

Answer 4

Alternating periods of short duration high-voltage activity (bursts) separated by lower-voltage activity (inter-bursts)

Question 5

What percentage of total sleep time should REM occupy in neonates?

Answer 5

Around 50%

Question 6

At what age does REM sleep decrease to 30% of total sleep time?

Answer 6

By the age of 6 months

Question 7

What EEG pattern is seen in teenagers (13-19 years)?

Answer 7

Continuous background with a well-defined alpha rhythm at 9-11Hz

Question 8

What characterizes the EEG of a 9-year-old?

Answer 8

Lambda activity may be present

Question 9

What is the dominant rhythm in toddlers (12-36 months) during wake?

Answer 9

5-6Hz posterior dominant rhythm, rising to 8Hz by 3 years

Question 10

What happens to alpha activity in children aged 3-5 years?

Answer 10

The amount of alpha increases with age

Question 11

What is the EEG response to hyperventilation in children?

Answer 11

High amplitude slowing often asymmetrical at onset and seen maximal posteriorly

Question 12

What is Ohtahara Syndrome?

Answer 12

Early infantile epileptic encephalopathy with frequent tonic spasms and focal motor seizures

Question 13

What EEG pattern is associated with Ohtahara Syndrome?

Answer 13

Burst suppression pattern

Question 14

What is Hypnagogic Hypersynchrony?

Answer 14

A normal variant of drowsiness seen in ages 3 months to 11 years, consisting of bursts of high voltage rhythmic activity

Question 15

What are the characteristics of sleep spindles in children aged 6-12 years?

Answer 15

Sleep spindles over the vertex, vertex sharp waves, and k-complexes in stage II

Question 16

What changes occur in sleep cycles from early childhood to later childhood?

Answer 16

Sleep cycle increases from 30-40 minutes to 90 minutes

Question 17

At what age should drowsiness be identifiable?

Answer 17

By 6 months of age

Question 18

What is the significance of corrected age in EEG evaluation?

Answer 18

Corrected age accounts for prematurity and is crucial for accurate assessment

Question 19

What is the EEG pattern for infants less than 29 weeks gestation?

Answer 19

Trace discontinu (continuously discontinuous and bilaterally asynchronous)

Question 20

What EEG pattern emerges at 26 weeks gestation?

Answer 20

Delta brush

Question 21

What is indicated by a background of low voltage irregular in wake and active sleep after 38 weeks gestation?

Answer 21

Indicates maturation of the EEG with normal patterns

Question 22

What are Delta Brushes?

Answer 22

Consists of delta with superimposed bursts of 8-10Hz activity

Question 23

What abnormalities are seen in premature and full-term neonates?

Answer 23

Marked asynchrony, focal or unilateral spikes, disorganized background

Question 24

What is the typical EEG pattern in a 5-month-old baby born prematurely?

Answer 24

Corrected age must be considered; EEG may not reflect maturity expected at 5 months

Question 25

What happens to alpha activity in drowsiness for ages 6-12 years?

Answer 25

Gradual alpha dropout replaced by increasing theta

Question 26

True or False: The EEG must be reviewed with flexibility and within the clinical context.

Answer 26

True