EEGs Flashcards
Electrode pop
phone ringing artifact
sweat artifact
Myogenic artifact
Chew artifact
glossokinetic artifact
Red arrow:
Blue circle:
Green Triangle:
Red arrow: Saccadic movements to left
Blue circle: Rightward eye movements(compensatory)
Green Triangle: lateral rectus spike
Fast alpha variant
Slow alpha variant
alpha squeak
Rhythmic mid-temporal theta bursts of drowsiness (RMTTBD)
Midline Theta
- What
- who:
- when:
- Description
- what: SREDA
- who: >50 years
- when: rest / drowsiness / HV
- Sudden buildup of rhythmic monomorphic theta/delta, mostly in temporoparietal region
SREDA:
Age:
When:
key differentiator
14 and 6 Hz
Age: peak = 13-14 years
When: Drowsiness / Light sleep
key differentiator: “ctenoid” appearance
14 and 6 Hz burst
What:
Age:
AKA (2) :
Key differentiator:
Benign sporadic sleep spikes (BSSS)
Age: adulthood
AKA: Small sharp spikes (SSS) or Benign epileptiform transients of sleep (BETS)
Key differentiator :no slow-wave component
wickett rhythm
Frontal arousal rhythm
mu
lambda
POSTS
Mitten pattern
Tremor artifact
how old is this baby?
26-28 weeks (Trace discontinue)
How old is this baby
30-38 weeks (trace alternant)
How old is this baby
29-30 weeks (delta brush)
PLEDS
What conditions is this associated with?
(TIRDA)
Ipsilateral hippocampal atrophy and MTS
What condition does this patient have?
LGS
(1.5-2 Hz Spike-and-wave, disorganized background)
Atonic seizure
ICU patient has this EEG, what is causing it?
Triphasic waves: most commonly metabolic encephalopathy (liver / kidney failure) btu can see in other toxic / metabolic Conditions
Triphasic waves, posterior-to-anterior lag
ICU patient
what is this?
What do we think causes it?
What does this significy
- Medium-to-high-voltages 1-3 Hz delta
- Pyramidal neurons in cortical layers II, III, and V.
- poor prognosis.
What is this?
What is the most likely cause of this EEG finding?
What are 5 other causes
GPEDS
- most caused following cerebral anoxia after cardiorespiratory arrest
- 5 other causes
- Severe metabolic disease
- Overdoses of Lithium
- Overdoses of Baclofen
- CJD
- Later stages of Subacute sclerosis encephalitis (SSPE)
Bust-suppression pattern
Brain-death criteria based on EEG (ACNS) 11 + 1
- Minimum 8 scalp electrodes + earlobe references
- Electrode Impedance between 100 - 10,000 ohms
- Interelectrode distance > 10 cm
- Sensitivity of 2 uV/mm
- time-scale 0.3-0.4 seconds
- Integrety of whole system tested
- “monitoring techniques should be kept in mind”
- Reactivity to pain and loud sound must be checked
- Assessment of adequate core body temperature
- Recording should last for 30 minutes
- Electroencephalographers should read EEG at bedside and are advised to repeat the following day if they suspect electrocerebral silence.
- No sedating medications on board
Spindle coma
alpha coma
Beta coma
Encephalopathic adult with this EEG. What should you suspect?
Stage 1 of Creutzfeldt-Jakob Disease (CJD)
Slowign and disorganization of background rhythms
Breech rhythm (skull defect)
Triphasic waves (reminder that these can be unilateral)
Wickets (1-3% of EEGS, most common in people >30 years)
What does each of the following indicate?
1
2
3
4
1 - Fp1/Fp2 positive corneal deflections (upward eye movement)
2 - Fp1/Fp2 negative corneal deflections (downward eye movement)
3 - F7 positive, F8 negative (looking left)
4 - F8 positive, F7 negative (looking right)
Photosensitive seizures:
- % of patients with epilepsy who have photosensitive seizures
- Male vs female prominence
- peak age at onset
- 5%
- 2/3 of patients are females
- Peak age of onset: 12-13 years
Define Photosensitivity regarding EEG
- generalized or occipital spike-wave or polyspike-waves which are highly correlate with clinical photosensitivity (90%)
Discharges in sleep.
- When are they most likely?
- When are they least likely?
- Most likely in N3 sleep
- Least Likely in REM
EEG Buzzwords:
- Bitemporal, independent period discharges
- Periodic, every 0.1-1 second
- Periodic, every 2-4 seconds
- Periodic, every 4-15 seconds
- Bitemporal, independent period discharges: Limbic encephalitis / HSV
- Periodic, every 0.1-1 second: CJD
- Periodic, every 2-4 seconds: HSV encephalitis
- Periodic, every 4-15 seconds: SSPE
Discharges in sleep:
Longest trains of Generalized spike-and-wave discharges are seen in _____, then ______.
N1 sleep (then N2)
Focal epilepsies in sleep:
- Stage of sleep focal seizures are most likely to occur
- Stage of sleep focal dischargs are most likely to occur
- Focal seizures most likely to occur in light sleep
- Discharges more likely to occur in slow-wave sleep
Subtypes of 6-Hz phantom spike-wave discharges (2)
WHAM
- Wake
- High-Amplitude
- Male
FOLD
- Female
- Occipital
- Low amplitude
- Drowsy
6-Hz Female Occipital Low-amplitude Discharges (FOLD), more associated with _____
Nauro-autonomic disturbances
in 6 Hz Wake High Amplitude Male (WHAM) discharges, what increases risk for seizures (3)
- higher in amplitude bursts
- 6 Hz
- persist in deeper stages of sleep
Adult with altered mental status, what is this?
Triphasic waves
Dyslexia trip-up:
Acronyms that can be confused, one associated with normal variant, another that can be associated with temporal lobe epilepsy
RMTD: Normal
TIRDA: associated with temporal lobe epilepsy
What is this
Hypnogogic hyperynchrony (note spindles after event)
feature helpful in differentiating wickett spikes from discharges
Wicket spikes don’t persist in deeper stages of sleep
