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Manikin orientation
Waveforms
The EEG waves are classified according to their frequency as:
Beta
(1320/sec)
Alpha
(812/sec)
Theta
(47/sec)
Delta
(13/sec)
Delta
Normal recording
Waveforms
Abnormalities of waveform include spikes and slow
waves.
waves
Spikes are characteristically paroxysmal, sharp, and of
high voltage followed by a slow wave. Spikes and slow
waves are associated with epilepsy, but some normal
patients may have this EEG finding.
Spikes
Polyspikes
Slow wave
Waveforms
Spikes & slow waves may be generalized or Focal.
Focal spikes are often associated with irritative lesions,
like cysts, slow-growing tumors, and glial scar tissue.
Focal Slow waves usually with less irritative
circumscribed lesion such as a hematoma, tumor,
infarction, or abscess;
Generalized spikes suggest generalized convulsions
Generalized slow waves suggest encephalitis or
encephalopathy like, metabolic, inflammatory, or
degenerative widespread process.
Epileptiform activity may be enhanced by activation
procedures, including hyperventilation
hyperventilation, photic
stimulation, and sleep deprivation.
deprivation
Periodic complex
Bursts of waves at regular intervals
Bursts of polyspikes: Myoclonic epilepsy
Bursts of slow waves:
Generalized: e.g. SSPE, Jacob disease.
Localized: e.g. Herpes encephalitis at temporal lobe
Patterns
3 spikespike-wave complex per second: Simple Absence
Chaotic trace: Hypsarrhythmia
Periodic Complex : Generalized or localized
Low voltage: severely suppressed brain
Localized slow waves: Focal lesion
Flat EEG: Brain death ECG waves may be transmitted
Synopsis
Simple absence: Staring, Generalized, 3 per second, Hyperventilation
Grand mal : Generalized, symmetrical, spikes and polyspikes
Hypsarrhythmia : Generalized chaotic in infant <1 year
Lennox
Lennox--Gastaut : Generalized spikes & slow waves in age 11-4 years
Myoclonic : Periodic complex of spikes and polyspikes, sleep
deprivation; neonatal or juvenile.
Partial : localized spikes and polyspikes e.g. centrotemporal Rolandic 5510 years & anterior temporal region Temporal lobe epilepsy
Test Time !
The coming slides are to apply the previous tips to
test your self.
Total of 20 EEG image. One minute and one mark
each.
You may face repeated image for same diagnosis.
1) 7 years
old
admitted
with
intractable
seizure on
multiple
drugs
15) Mother was scared at night after grunting sound of her child
17) 3 years old child with altered level of consciousness & fever
GO O D
L UC K
EL-BABA M.A. 2010