Terminology

Question 1

G

Answer 1

Generalized

Question 2

BI

Answer 2

Bilateral Independent

Question 3

Mf

Answer 3

multifocal

Question 4

PD

Answer 4

Periodic Discharges

Question 5

SW

Answer 5

Rhythmic Spike and Wave
Rhythmic Sharp and Slow Wave
Rhythmic Polyspike and Wave

Question 6

RDA

Answer 6

Rhythmic Delta Activity

Question 7

Modifier +F

Answer 7

superimposed fast activity (PD or RDA only)

Question 8

Modifier +R

Answer 8

superimposed rhythmic activity (PD only)

Question 9

Modifier +S

Answer 9

superimposed sharp waves or spikes, sharply contoured (RDA only)

Question 10

Modifier +FR

Answer 10

both superimposed fast activity and superimposed rhythmic activity (PD only)

Question 11

Modifier +FS

Answer 11

both superimposed fast activity and superimposed sharp waves, spikes, sharply contoured waves (RDA only)

Question 12

Generalized - meaning

Answer 12

Widespread throughout EEG
Can have a predominant feature
I.E. Frontally predominant, occipitally predominant, etc

Question 13

Lateralized - meaning

Answer 13

Unilateral (one side) or Bilateral (both sides)
Specify lobe (i.e. occipital, etc)

Question 14

Bilateral Independent-meaning

Answer 14

Specify symmetric or asymmetric
Specify which Lobe(s)
occurring on both sides of the brain

Question 15

Multifocal - meaning

Answer 15

Specify symmetric or asymmetric
Specify which Lobe(s)
emanating from several locations

Question 16

Periodic Discharges

Answer 16

discharges occurring periodically throughout study

Question 17

SW

Answer 17

Rhythmic Spike and Wave
Rhythmic Sharp and Slow Wave
Rhythmic Polyspike and Wave

Question 18

SW

Answer 18

Rhythmic Spike and Wave
Rhythmic Sharp and Slow Wave
Rhythmic Polyspike and Wave

Question 19

B(I)RD

Answer 19

Commonly written as “BIRDs”
Highly correlate with Ictal activity
Less than 10 seconds in Length (ACNS considers this to “Very Brief” if you’re getting technical)
Classified as:
B Brief
(I) Ictal/Interictal
R Rhythmic
D Discharges

Question 20

SIRPID

Answer 20

Focal or generalized
Caused by Stimulation to the patient
Patients are typically comatose, stuporous or obtunded
Described as LPD, PD, spike-wave, triphasic
Defined as:
S Stimulus
I Induced
R Rhythmic
P Periodic
I Ictal/interictal
D Discharges

Question 21

GRDA

Answer 21

Activity is Generalized (G)
It is Rhythmic Delta activity (RDA)
No + ( )

Question 22

LPD+FR

Answer 22

Activity is Lateralized (L)
It is Periodic (PD)
It has both Superimposed Fast frequencies as well as Rhythmic (+FR)

Question 23

GSW

Answer 23

Activity is Generalized (G)
It is Rhythmic spike and wave (SW)
No + (does not apply to SW)

Question 24

BIPD

Answer 24

Bilateral Independent (BI)
Periodic Discharges (PD)
No + ( )

Question 25

GPD+R

Answer 25

Activity is Generalized (G)
Periodic Discharges (PD)
Rhythmic (+R)

Question 26

GPD+R
B(I)RD

Answer 26

Generalized (G)
Periodic Discharges (PD)
Rhthmic (+R)

B(I)RD
<10 seconds

Question 27

LRDA

Answer 27

Activity is Lateralized (L)
It is Rhythmic Delta Activity (RDA)
No + ( )

Question 28

Symmetry report description

Answer 28

a. Symmetric

b. Mild asymmetry (consistent asymmetry in amplitude on referential recording of <50%, or consistent asymmetry in frequency of 0.5 - 1 Hz)

c. Marked asymmetry (>50% amplitude or >1 Hz frequency asymmetry).

Question 29

Breach effect report description terms

Answer 29

presence, absence, or unclear

Question 30

Posterior dominant “alpha” rhythm (PDA) report description

Answer 30

a. Specify frequency (to the nearest 0.5 Hz)
b. Absence of clear PDA

Question 31

Predominant background EEG frequency report description

Answer 31

Delta, Theta, and/or >Alpha. If 2 or 3 frequency bands are equally prominent, record each one.

Question 32

Anterior-posterior (AP) gradient

as reported

Answer 32

Present, absent or reverse.

An AP gradient is present if at any point in the epoch, there is a clear and persistent (at least 1 continuous minute) anterior to posterior gradient of voltages and frequencies such that lower amplitude, faster frequencies are seen in anterior derivations, and higher amplitude, slower frequencies are seen in posterior derivations. A reverse AP gradient is defined identically but with a posterior to anterior gradient of voltages and frequencies

Question 33

Variability

as reported

Answer 33

yes, No, or unknown/unclear/not applicable.

The last choice might apply, for example, in a 30-minute awake record

Question 34

Reactivity

as reported

Answer 34

Yes, No, or Unclear/unknown/not applicable.

Change in cerebral EEG activity to stimulation

This may include change in amplitude or frequency, including

Question 35

Voltage

as reported

Answer 35

a. Normal
b. Low (most or all activity <20 μV in longitudinal bipolar with standard 10-20 electrodes, [measured from peak to trough])
c. Suppressed (all activity <10 μV). If discontinuous, this refers to the higher amplitude portion

Question 36

Stage II sleep transients (K-complexes and spindles):

as reported

Answer 36

a. Normal (K-complexes and spindles both present and normal)
b. Present (at least one) but abnormal
c. Absent (both absent)

Question 37

Continuity

as reported

Answer 37

a. Continuous.
b. Nearly Continuous: continuous, but with occasional (<10% of the record) periods of attenuation or suppression. Describe typical duration of attenuation/suppression as
above.
i. Nearly continuous with attenuation: periods of lower voltage are >10μV but <50% of the background voltage
ii. Nearly continuous with suppression: periods of lower voltage are <10 μV
iii. If suppressions/attenuations are stimulus-induced, code as “nearly continuous with SI-attenuation” or “…with SI-suppression”
c. Discontinuous: 10-49% of the record consisting of attenuation or suppression, as defined above.
d. Burst-attenuation/Burst-suppression: more than 50% of the record consisting of attenuation or suppression, as defined above, with bursts alternating with attenuation or
suppression; specify the following:
i. Typical duration of bursts and interburst intervals
ii. Sharpest component of a typical burst using the sharpness categories defined above under modifiers
iii. Presence or absence of Highly Epileptiform Bursts: Present if multiple epileptiform discharges (traditional definition) are present >1/sec, or a rhythmic, potentially
ictal-appearing pattern >1 Hz is seen within the majority (>50%) of bursts; record typical frequency (using categories above) and location (G, L, BI or Mf).
e. Suppression: entirety of the record consisting of suppression (<10 uV, as defined above)

bursts must average more than 0.5 seconds and have at least 4 phases (polyphasic); if shorter or fewer phases, they should be considered single discharges. Bursts
within burst-suppression or burst-attenuation can last up to 30 seconds.

Question 38

Daily Pattern Duration

Answer 38

defined as total duration of a pattern per 24 hours

Question 39

Daily Pattern Index

Answer 39

defined as Daily Pattern Duration X Mean Frequency (Hz)