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Abnormal EEG brain in neurological disease

Abnormal EEG brain in neurological disease. แพทย์หญิง กาญจนา พิทักษ์วัฒนานนท์ อายุรแพทย์ผู้เชี่ยวชาญระบบประสาท แพทย์ประจำศูนย์สมอง โรงพยาบาลสมิติเวชศรีราชา. 10 – 20 system. Records the difference between two Active scalp electrodes. Bipolar montage. Active scalp electrode

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Abnormal EEG brain in neurological disease

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  1. Abnormal EEG brain in neurological disease แพทย์หญิง กาญจนา พิทักษ์วัฒนานนท์ อายุรแพทย์ผู้เชี่ยวชาญระบบประสาท แพทย์ประจำศูนย์สมอง โรงพยาบาลสมิติเวชศรีราชา

  2. 10 – 20 system

  3. Records the difference between two Active scalp electrodes Bipolar montage

  4. Active scalp electrode • Inactive scalp / ear electrode : A1 , A2 Referential montage

  5. Reference / Bipolar montage

  6. If the voltage input from electrode 2 is relatively “ positive ” compared to electrode 1 , then the pen will deflect “ up ” • If electrode 2 is relatively “ negative ” compared to electrode 1 , then the pen will deflect “ down ” • If electrode 1 equal to electrode 2 , then the pen stay “ baseline ” Polarity

  7. Different Montage : Polarity

  8. Identify background rhythms ( frequency ) • Alpha 8 -13 Hz • Beta 13 – 40 Hz • Theta 4 – 8 Hz • Delta < 4 Hz • Mu 7 – 11 Hz • Sleep stage ( awake , NREM , REM ) • Identify any abnormal patterns • Slow patterns • Diffusely , Focally • Symmetry , Asymmetry • Paroxysms • Spike , spike and wave complex , sharp wave • Triphasic waves • PLEDs ( Periodic lateralizing epileptiform discharges ) • Localize those abnormal patterns • Maximum amplitude ( Referential montage ) • Phase reversal / Reciprocal changes ( Bipolar montage ) EEG interpretation

  9. Background rhythm / frequency

  10. Sleep stage : Background

  11. Epilepsy

  12. Common • Sleep deprivation , • Alcohol withdrawal , • Television flicker , • Systemic infection , Head trauma , • Recreational drugs , antiepileptic drug , • Menstruation • Occasional • Dehydration , • Barbiturate / Benzodiazepine withdrawal , • Hyperventilation, • Flashing lights , • Diet and missed meals , • Specific reflex trigger , • Stress , Intense exercise Factor lowering seizure threshold

  13. Rountine electroencephalograms • Hyperventilation • Photic stimulation • Sleep-deprivation • Prolonged ambulatory recording • Video – EEG telemetry • Magnetoencephalography : Research Activation tecniques ( EEG )

  14. Seizure

  15. Epileptiform discharge / Spike

  16. Focal seizure : spike ( phase reversal )

  17. Herpes simple encephalitis • PLEDs ( Periodic lateralizing epileptiform discharges )

  18. IctalEEG : Spike and waves complexs

  19. Generalized seizure

  20. Absence seizure 3 Hz spike and wave complexs

  21. Syndrome of epilepsy

  22. Syndrome of epilepsy

  23. CJD – Mad cow disease Diffused slow pattern : encephalopathy

  24. Prion encephalitis • Triphasicwaves

  25. Severe dementia • Triphasicwaves : degenerative disease

  26. Encephalopathy

  27. Comatose

  28. Brain death

  29. Sleep or Death

  30. Sleep Spindle

  31. Sleep spindle / K complex

  32. Sleep

  33. Sleep Lab / Polysomnography

  34. Hypnogram

  35. Eye Blink Artifact

  36. Artifact

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