Canadian Board of Registration of Electroencephalograph

Technologists, Inc.

INFORMATION HANDBOOK

Page

GENERAL BACKGROUND INFORMATION 1

OVERVIEW OF THE REGISTRATION PROCESS1

BECOMING A C.B.R.E.T. CANDIDATE 2

TRAINING PROGRAM APPROVAL

2

WRITTEN EXAMINATION

3

RECIPROCITY FOR FOREIGN CANDIDATES 3

PRACTICAL

EXAMINATION

6

APPENDIX A: Exam Content 9-10 Sample Multiple Choice Questions 10-11

______________________________________________________________________________________________

Inquiries and requests for application forms should be addressed to:

Rohit (Roy) Sharma, RET, REPTManager: Neurophysiology Lab-6C

Registrar, C.B.R.E.T. IncDivision of Neurology

The Hospital for Sick Children555 University Ave

Toronto, Onatrio, M5G 1X8phone: 416-813-6545pager:  416-232-5667

e-mail: roy.sharma@sickkids.ca

GENERAL BACKGROUND INFORMATION

The Canadian Board of Registration of Electroencephalograph Technologists, Inc. (C.B.R.E.T., Inc.) was established in 1972 to improve the standards of knowledge and proficiency in EEG technology and to promote a degree of uniformity in the training of EEG technologists in Canada.

C.B.R.E.T., Inc. was established to fulfill the following objectives:

i) To establish standards for institutions where EEG training is to take place.

ii) To promote high academic standards for the training of EEG technologists.

iii) To conduct examinations in order to test the knowledge and proficiency of EEG technologists.

iv) To issue certificates designating those meeting the standards of Registered Electroencephalograph Technologists (R.E.T.).

v) To maintain a current register of those technologists having successfully passed the examinations and obtained RET status.

The Board consists of 10 members, each serving a three (3)-year term which can be renewed once. The Chairperson of the Board is always a physician and the Registrar is a technologist. Other Board Members include one (1) physician or technologist from each of the five (5) C.B.R.ET., Inc. regions in Canada (Atlantic, Quebec, Ontario, Prairies, and B.C.), one (1) technologist from the Executive Board of the Canadian Association of Electroneurophysiology Technologists, Inc. and two (2) members are appointed at large.

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OVERVIEW OF THE REGISTRATION PROCESS

Registration is obtained upon successful completion of the C.B.R.E.T. Inc. Written and Practical examinations. Upon successful completion of both examinations the applicant becomes a Registered EEG Technologist (R.E.T.) and may use these trademarked initials.

Hospital training programs and college programs must meet established requirements in order to enable the candidate to be eligible for registration. Questions regarding training program eligibility should be directed to the Registrar.

C.B.R.E.T., Inc. examines to the standards contained in the C.A.E.T. Inc. National Competency Profiles (adopted in 2007) and the C.A.E.T Inc. Minimal Technical Standards - Clinical Electroencephalography (Approved June 1991, Revised 2001).

Becoming a Candidate

All applicants are required to register as a candidate to enter the exam process. Persons who have received training in Canada must register as a Candidate one (1) year prior to taking the Written examination. Foreign applicants must register as a Candidate before their qualifications are reviewed to determine eligibility. Candidacy application forms can be obtained by contacting the Registrar.

Candidacy Fee $50.00

Language of Examinations

The entire C.B.R.E.T., Inc. exam is offered in English and French. Candidates must indicate at the time of making application for the examination the language in which they wish to be examined.

Training Program Requirements

EEG Technologists in Canada are trained either through college diploma programs in Neurophysiology or in-hospital EEG training programs. In order

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for students to be eligible for the C.B.R.E.T. Inc. Examinations, all training programs must obtain C.B.R.E.T. Inc approval.

To obtain C.B.R.E.T. Inc approval, all training programs must submit a detailed course syllabus for review by the C.B.R.E.T Inc. Board of Directors. Submission must include the following; detailed course outline which includes course structure, timetables, and lecture topics. The submitted materials will be cross referenced to the CAET National Competency Profiles and C.B.R.E.T. Inc approval granted on based on adequate coverage of all aspects of the Competency Profiles. Additional requirements are as follows:

i) The training facility must have written confirmation from C.B.R.E.T., Inc. that they have been approved. Approval is subject to review at the discretion of the C.B.R.E.T. Inc Board of Directors.

ii) The facility must be registered with C.B.R.E.T. Inc., as a training facility for one (1) year prior to a candidate’s eligibility for the Written examination.

iii) Training programs must be a minimum of two years in length.Hospital-Based Programs:iv) Must include 10 hours of didactic instruction per week for student technologists.v) Have at least one (1) C.B.R.E.T. Inc., Registered Technologist.vi) Have a full time or major part-time Electroencephalographer who is an M.D. and

a member of the C.S.C.N.College Diploma Programs:vii) Diploma program must include a minimum of 500 hours of EEG instruction.

Training Program Approval Fee:

Effective June 2008, all training programs seeking approval by C.B.R.E.T. Inc. must pay a $500 fee to fund the cross-referencing of the program’s course syllabus to the Competency Profiles. This fee is not retro-active to those programs already approved by C.B.R.E.T. Inc.

Written Examination:

ELIGIBILITY

1. EDUCATIONAL REQUIREMENTS

Proof of ONE (1) of the following:a) Successful completion of the last grade of high school.b) Being eligible to write university entrance examinations.c) Having fulfilled requirements to continue as a mature student at a

University in the province of residence.d) In very exceptional cases having demonstrated to the Board an ability to

satisfy any of the above.

2. TRAINING REQUIREMENTS

Hospital-Based Training Programs:

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Candidates must have a period of ONE (1) YEAR (plus or minus two (2) weeks from the exam date) of training in a C.B.R.E.T. approved training facility. The candidate must include a letter from their supervising R.E.T. stating that all the requirements of training have been met.

College-Based Training Programs:Successful completion of a diploma program in Neurophysiology. Candidates must include a copy of a transcript from the Electrophysiology courses attended and a copy of a diploma, or equivalent, which indicates successful completion of the program.

RECIPROCITY

C.B.R.E.T., Inc. does not have reciprocal arrangements with any other country. EEG training received outside Canada may be accepted towards eligibility into the C.B.R.E.T., Inc. exam system as follows:

i. Applicants with a minimum of 4000hrs (2 years full-time) of clinical experience as an independent (outside of a student or trainee role) EEG Technologist in their country of origin:Applicants must include:

a. Documentation of education/training in EEG in the form of copies of college diploma, training or registration certificates.

b. Letters from employers documenting years of experience, including reference to the number of hours worked. The 4000hr requirement must be met within 5 years of the date of application.

c. Work placement in Canada and completion of a three month apprenticeship in EEG in addition to recommendation from a R.E.T. to support eligibility for the C.B.R.E.T. Inc. examinations. Applicants must be registered with C.B.R.E.T. as a candidate prior to the start of the three month apprenticeship. Work placement is the sole responsibility of the individual.

ii. Applicants with less than 4000hrs of clinical experience in EEG in their country of origin:In addition to the above requirements, these candidates must also complete the following prior to becoming eligible for the Practical examination:

a. Personal recordings of 500 EEGs under the direct supervision of an R.E.T. in Canada as follows: (a) 400 adults plus 100 children 12 years of age or younger, with at least 20 of those children being under the age of two (2) years, or (b) 400 children plus 100 adults 21 years of age or older, with at least 20 of those adults being over the age of 60 years. EEGs recorded by the candidate are accepted towards the total of 500 recordings. Documentation of these recordings in the form of a logbook must be presented at the Practical examination.

WRITTEN EXAMINATION DATE AND PLACE

The Written Examination is offered twice per year (effective 2009) as follows:

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Fall Examination SessionThe written exam is held on the third Monday in September in nine (9) cities across Canada: Vancouver, Edmonton, Saskatoon, Winnipeg, Toronto, Montreal, Halifax, Charlottetown, and St. John’s. The exam is usually held at a University/Hospital in each city and proctored by a volunteer. Candidates are notified of the exact time and location 3-4 weeks in advance of the examination. Spring Examination SessionA second seating of the written examination is held in conjunction with the Practical examination held in the Spring of each year. The Spring seating of the Written examination is only offered at the location where the Practical examination is being held.

WRITTEN EXAMINATION APPLICATION PROCEDURE

i. Registered as a C.B.R.E.T., Inc. candidate for at least one (1) year. This time period may be re-evaluated at the discretion of the C.B.R.E.T. Inc Registrar.

ii. Complete a Written Exam application form. Application forms may be obtained by contacting the Registrar.

iii. Obtain proof of educational and training requirements.iv. Forward the completed written examination application form,

proof of education and training requirements, and the exam fee to the Registrar before the July 1st deadline.

v. Applicants must be current members of the Canadian Association of Electroneurophysiology Technologists (CAET Inc). Please contact the CAET Secretary/Treasurer for membership information.

REGISTRATION DEADLINE

Registration for the Fall Written Exam session must be completed and received by July 1st of each year. The registration deadline for the Spring session is January 15th.

Written Examination Fee $300.00

REFUNDS

Full refunds will be issued to candidates who notify the Registrar of their intention to withdraw at least one month prior to the date of the examination. No refunds are issued after this date.

WRITTEN EXAM FORMAT

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The C.B.R.E.T., Inc. Written Examination is a three (3) hour, 100 question multiple choice exam. Each question has only one (1) correct answer. The exam is divided into three (3) sections:

1) Technology2) Clinical EEG and Activation Procedures3) Clinical Epilepsy, Neurology, and Neuroanatomy

Effective for the 2010 Written examination the examination blueprint will be as follows:

CAET Competency Profile Total WeightSection 1- Professional Accountability and Responsibility 5%-10%Section 2- Workplace Health and Safety 10%-15%Section 3- Patient Centered Care 10%-15%Section 4- Operation of Equipment 20%-25%Section 5- Clinical Procedures 20%-25%Section 6- Interpretation and Analysis 20%-25%

Passing Grade is 70 %. See APPENDIX A for a list of the areas covered in each section and sample multiple choice questions.

REPORT OF RESULTS

All candidates are notified of a pass/fail within four (4) weeks of the exam date. Absolute marks are not disclosed but candidates are informed of their strengths and weaknesses on the three areas of the exam.

FAILURE OF THE WRITTEN EXAMINATION

A candidate who fails the written exam may reapply and repeat the exam within two (2) years, by completing a second Written Examination application form and submitting the examination fee prior to the deadline. In the event a candidate fails the written examination three (3) times, they must wait a minimum of two (2) years, and at that time reapply to become a C.B.R.E.T., Inc. candidate and show proof of further training in EEG. A letter from the candidate’s supervisory technologist is required documenting the additional training received.

Practical Examination

ELIGIBILTY

Hospital-Based Programs:Evidence of all of the following:

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i) Training in an EEG department approved by the Board for a period of twenty-four months, with the exception of holidays permitted under the various collective agreements. The candidate must have trained for the entire twenty-four months under the direct supervision of an R.E.T. in the same department.

ii) Personal recordings, under direct supervision of an R.E.T., of at least 500 EEGs: (a) 400 adults plus 100 children 12 years of age or younger, with at least 20 of those children being under the age of two (2) years, or (b) 400 children plus 100 adults 21 years of age or older, with at least 20 of those adults being over the age of 60 years.

iii) Support of the supervisory R.E.T. in the Department where the majority of recordings were performed.

iv) The candidate must maintain a logbook of the required 500 recordings. Each logbook entry MUST contain the following information on each recording – Patient ID, age, date of recording, referring diagnosis and the signature of the supervising R.E.T. The candidate will be required to produce the log book at the Practical Examination site. The candidate must have documentation from a Registered EEG Technologist(s) confirming that the required number of EEGs have been performed.

College Diploma Programs:Evidence of all of the following:i) Graduation from a two (2) year diploma programii) Personal recordings, under direct supervision of an R.E.T., of at least 500 EEGs:

(a) 400 adults plus 100 children 12 years of age or younger, with at least 20 of those children being under the age of two (2) years, or (b) 400 children plus 100 adults 21 years of age or older, with at least 20 of those adults being over the age of 60 years. EEGs recorded by the candidate at college practicum sites are accepted towards the total of 500 recordings.

iii) The candidate must maintain a logbook of the required 500 recordings. Each logbook entry MUST contain the following information on each recording – Patient ID, age, date of recording, referring diagnosis and the signature of the supervising R.E.T. The candidate will be required to produce the log book at the Practical Examination site. The candidate must have documentation from a Registered EEG Technologist(s) confirming that the required number of EEGs have been performed.

PRATICAL EXAMINATION APPLICATION PROCEDURE

i. Obtain and complete a Practical Examination application form and submit along with applicable fees to the C.B.R.E.T. Inc Registrar.

ii. Provide documentation of completion of above requirements.

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PRACTICAL EXAMINATION DATE AND PLACE

The Practical examination is offered once annually at either one (1) or two (2) sites in Canada. If two (2) sites are offered, one (1) will be east of the Ontario/Manitoba border and one (1) west. Exam(s) usually are held on Saturday(s) in April or May.

Practical Examination Fees

Full Practical Examination (Includes Practical, Oral, Record Review) $500Individual Section Examination FeesPractical Section $200.00Record Review Section $200.00Oral Section $200.00

DEADLINE FOR REGISTRATION

Registration for the Practical Examination must be completed and received by January 15th of each year.

REFUNDS

Full refunds will be issued to candidates who notify the Registrar of their intention to withdraw at least one month prior to the date of the examination. No refunds are issued after this date.

PRACTICAL EXAMINATION FORMAT

Practical/Head Measurement SectionThe candidate is given one (1) hour to take a patient history, measure and apply electrodes. Your examiners will evaluate your competence in accurate, secure electrode application as well as established patient rapport.Electrodes may be applied with either paste or collodion. Electrodes are to be applied using the 10/20 Head Measurement System. Impedances are not checked, therefore the candidates will not abrade their patients scalp prior to application. Continuous air from wall outlet may be available, depending on site facilities. Candidates are required to bring their own electrodes, compressed air pumps with foot pedals, and all other supplies that are necessary. Needle electrodes and electrocaps may not be used for this section of the examination.

Record Review SectionEach candidate is required to bring to the exam two (2) abnormal EEG recordings that they have recorded, unassisted, during the training period. Of these, one (1) must be a pediatric record (12 years or younger) and one

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(1) adult (21 years or older). The EEG tracings may be analogue or digital recordings. Digital recordings may be presented via a laptop computer supplied by the candidate or training facility or in the form of computer print-outs. Due to the variation in EEG software- availability of browsing software may not be available at all examination sites. Monitors can be made available at the examination site for better viewing purposes. It is the candidate’s responsibility to ensure their records are available to be read on the day of the examination.During a 90 minute period, the examiners will first review the records, then review the records with the candidate. The two (2) recordings are returned to the candidate following this section of the exam.

Oral SectionThe Oral Exam will last approximately 60 minutes during which time the candidate will be shown EEG samples and diagrams pertaining to the areas listed in Appendix A. Questions are asked by two (2) or three (3) examiners.

REPORT OF PRACTICAL EXAMINATION RESULTS

Candidates will receive the results of the exam within four (4) weeks. Successful candidates will also receive a C.B.R.E.T., Inc. Registration Certificate at this time. The decision of the examiners is final.

FAILURE OF THE PRACTICAL EXAMINATION

The Oral, Record Review, and Practical portions of the exam are marked separately. A candidate can successfully complete one (1) part of the exam and then repeat the remaining portion(s) within two (2) years. A candidate who is unsuccessful in three (3) attempts or a candidate who waits longer than two (2) years to repeat the exam will be required to reinitiate the entire examination process which will involve re-application following documentation of additional training and repeating the written examination.

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APPENDIX A

C.B.R.E.T., Inc. EXAM CONTENT *

TECHNOLOGYElectrode application: 10-20 measuring system technique and theoretical basis. Extra electrode positions. Measuring technique for asymmetrical heads and surgical scars. Properties of electrodes, polarized and non-polarized metals. Nasopharyngeal and sphenoidal electrodes. Measuring electrode impedance. Desirable electrode impedance values.EEG Machine: Functions of the preamplifier, differential amplifier, effects of input impedance, Digital EEG concepts and instrumentation, including Analog-to-Digital Converter (ADC), sample rate, Sample skew, ADC precision (vertical resolution), aliasing, digital calibration, system reference electrode, reformatting and montages, and screen display. Basic computer components (i.e. CPU, RAM, networking etc.) and their function(s). Archiving, retrieval and printing. Understanding of common mode rejection and factors that affect it. Calculation of sensitivity values. Indication for varied paper speeds.Polarity: EEG convention. Cancellation. Localization on referential and bipolar montages. Advantages and disadvantages of bipolar and referential montages.Artifacts: Environmental, mechanical, and physiological causes. Recognition, localization and elimination of artifacts. Placement of electrodes, and indications for monitoring of respiration, eye movements, and muscle jerks or twitches. Types of transducers (e.g. thermistors, electrical crystal, and impedance pneumography).Electronics: Ohm’s Law. Calculation of resistance, voltage and current in series or parallel circuits. Properties of individual electronic components (e.g. Resistor, capacitor, voltage sources, transistors). Capacitance, electromagnetism, and induction. Properties of a good conductor.Electrical Safety: Understanding of the ground electrode, ground loops and leakage current. CSA acceptable levels of leakage current. Recognition of electrically susceptible patients, and prevention of electrocution.

CLINICAL EEG AND ACTIVATION PROCEDURESThe Normal EEG: Descriptive features and identification of waveforms in the normal waking and sleep EEG of adults and children. Normal Variants. Basic Neonatal EEG. Maturation of the EEG from infancy to old age.Hyperventilation: Method and mechanism. Metabolic changes. Normal and abnormal responses at all ages. Indications and contraindications.Photic Stimulation: Normal and abnormal responses. Photoparoxysmal and photomyogenic response. Indications. Type of disease process activated by photic stimulation.Sleep: Sleep stages. The use of sleep as an activator. The normal sleep cycle. Narcolepsy, sleep apnea, and night terrors. Neonatal sleep stages.Clinical EEG: The use of and EEG findings in the investigation of epilepsy, tumors, infections, head injuries, coma, cerebrovascular disease, psychiatry, dementia, anoxia, metabolic and toxic conditions. Alpha coma, burst suppression, triphasic waves, and PLEDS.Electrocerebral Silence: Definition, minimum technical requirements, identification and elimination of artifacts. Causes of transient ECS.

CLINICAL EPILEPSY, NEUROLOGY, ANATOMY, MEDICATIONSSeizures: Knowledge of the International Classification of Seizures. Clinical expression of all generalized, partial and secondarily generalized seizures. Anatomical localization of seizure symptoms. Activation procedures indicated for

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common seizure types. Care of the patient during a seizure. Aura’s, Todd’s paralysis, Pseudoseizures, Epilepsia Partialis Continua, Status Epilepticus.Basic neurology: Clinical and EEG features of the following conditions: migraine headaches; vascular disease such as stroke, and transient ischemic attacks. Degenerative diseases including Alzheimers, Jacob Creutzfeldt, white and grey matter degeneration. Coma, Drug Overdose; Faints; Hydrocephalus; Tumors; Metastatic Disease; Brain Abscess; Encephalitis; Meningitis; Multiple Sclerosis; Reye’s Syndrome; S.S.P.E.; and Tuberous Sclerosis. Upper motor neuron VS lower motor neuron signs.Neuroanatomy: Gross anatomy of the head and neck. Lobes and main fissures of the cerebral hemispheres and their relation to the skull and scalp. Anatomical correlates with the 10-20 system routine and extra electrode positions. The main subcortical structures including the cerebellum, brain stem and spinal cord. Cortical areas concerned with motor, sensory and speech functions. Arterial and venous supply of the brain. Knowledge of the location and function of the cranial nerves. The formation and circulation route of cerebro-spinal fluid. The meninges. Basic knowledge of the structure of the neuron, action potentials, synaptic potentials, inhibitory and excitatory potentials. Properties of the neuromuscular junction.Medications: The indication, toxicity and effect on the EEG of anticonvulsant medication, barbiturates, tranquilizers, sedatives and hypnotics. Contraindications to sedation.

EEG Clinical Competency  Workplace Health and Safety, Patient-Centered Care and Professional Accountability and Responsibility

SAMPLE MULTIPLE CHOICE QUESTIONS *

TECHNOLOGY

1. What is the voltage of a spike that measures 15mm peak to peak at sensitivity 10 uV/mm?

a) 1.5 uVb) 5 uVc) 15 uVd) 50 uVe) 150 uV

2. In the EEG Figure 5, which is the most involved electrode?a) Fp1b) F7c) T3d) T5e) O1

3. Using the 10 - 20 International Measuring system, the distance transversely between F7 and F8 is 22 cm. What will be the distance between F4 and F3?

a) 2.2 cmb) 4.4 cmc) 5.5 cmd) 11 cme) 16.5 cm

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4. Constant use of a High Frequency filter setting of 15hz during a normal wake and sleep record other than reducing muscle artifact, would

a) Decrease the frequency of beta.b) Decrease the frequency of alpha.c) Cause no change in any activity of brain origin. d) Decrease the amplitude of beta and sleep spindles.e) Decrease the amplitude of drowsy theta and hyperventilation build-up.

5. Which of the following would be the most appropriate action given the EEG in Figure 1?a) Monitor respiration.b) Increase paper speed.c) Test patient reactivity.d) Apply 2 infraorbital electrodes and refer to ipsilateral ear.e) Apply 2 outer canthi electrodes and refer to ipsilateral ear.

CLINICAL EEG AND ACTIVATION PROCEDURES

6. The degree of EEG response to hyperventilation will NOT be influenced bya) ageb) genderc) postured) blood sugare) degree of gas exchange

7. A patient has seizures beginning with numbness of the left hand. The electrode positions most likely to record its origin are

a) C4 and F4b) C4 and T4c) C4 and P4d) Cz and P4e) Cz and C4

8. Cerebral infarction can produce all of the following EEG abnormalities EXCEPTa) PLEDsb) Focal thetac) Small sharp spikesd) Depression of sleep spindles unilaterallye) Focal diminution of voltage of cerebral activity

9 . The technologist arrives in ICU to record the EEG. He has been told Mr. D is in room 15.  The patient does not respond when his name is called.  To confirm the patient’s identity, the technologist should:

a)      Ensure names on patient chart and requisition match.b)      Ensure names on patient wristband and requisition match. c)      Ask the attending nurse to confirm patient’s name.d)      Ensure the names on patient room and requisition match.

Reference:  Basic Medical Techniques and Patient Care in Imaging Technology (Torres) pg 14 Competency: 3.2a   

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CLINICAL EPILEPSY, NEUROLOGY, ANATOMY, MEDICATIONS

10. A lesion in the right optic tract will result in a loss of vision ina) the left eyeb) the right eyec) both nasal fieldsd) the left visual fielde) the right visual field

*The examination content and sample multiple choice questions are offered as reference material only.

Proposed Reference Materials for Exam Preparation

1. Abou-Khalil, B., Misulis, K.E., Atlas of EEG and Seizure Semiology. Butterworth-Heinemann, 2005.

2. American Clinical Neurophysiology Society Guidelines in Electroencephalography, Evoked Potentials, and Polysomnography. www.acns.org. 2006.

3. Aminoff, M.J. (ed.) Electrodiagnosis in Clinical Neurology, 5th ed. Churchill Livingstone, 2005.

4. Altman, C. “Infection Control: 2000 Review and Update for Electroneurodiagnostic Technologists.” American Journal of Electroneurodiagnostic Technology. 40(2) pp 73 – 97, 2000.

5. Bloome, WT., Kalibara., M., Young.,GB. Atlas of Adult Electroencephalography, 2nd Edition. Lippincott, Williams & Wilkins, 2002.

6. Canadian Association of Electroneurophysiology Technologists Inc. Code of Ethics. CAET, 1994.

7. Canadian Association of Electroneurophysiology Technologists Minimal Technical Standards. CAET, 2001.

8. Canada’s National Occupations health and Safety Website. www.canoshweb.org

9. Canadian Centre for Occupational Health and Safety. www.ccohs.ca

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10. Ebersole, J.S. and Pedley, T.A. (eds.) Current Practice of Clinical Electroencephalography, 3rd Edition. Lippincott Williams & Wilkins. 2003.

11. Fisch, B.J. Fisch & Spehlmann's EEG Primer: Basic Principles of Digital and Analog EEG, 3rd Revised and Enlarged Edition. Elsevier. 1999.

12. Goldensohn E.S. (ed) et al Goldensohn’s EEG Interpretation: Problems of Overreading and Underreading, 2nd Edition. Futura. 1999.

13. Health Canada Infection Control Guidelines (July 1999, Volume 25 S4). Routine Practices and Additional Precautions for Preventing the Transmission of Infection in health Care.

14. Krass, G.L. and Fisher. R.S. The Johns Hopkins Atlas of Digital EEG: An Interactive Guide. Johns Hopkins Press, 2007.

15. Misulis, K.E., Essentials of Clinical Neurophysiology, 2nd Edition. Butterworth-Heinemann. 1997.

16. Mizrahi, E.M., Hrachovy, R.A., Kellaway, P. Atlas of Neonatal Electronencephalography, 5th ed. Urban and Schwarzenberg, 2004.

17. Neidermeyer, E., Da Silva, Fernando. Electroencephalography: Basic Principles, Clinical Applications and Related Fields, 5th edition. Lippincott, Williams & Wilkins. 2005.

18. Noachtar, S., Wyllie, E. Electroencephalographic Atlas of Epileptiform Abnormalities in the Treatment of Epilepsy: Practice & Principles. 4th Edition., 2006: 183-214.

19. Office of the Privacy Commission of Canada www.privcom.ca

20. Purtilo, Ruth. Ethical Dimensions in the Health Professions. 3rd edition. 1999.

21. Purtilo, R., and Haddad, A. Health Professional and Patient Interaction. 5th edition. 1996.

22. Stern, JM., Engel, J. Jr. Atlas of EEG Patterns. Lippincott, Williams & Wilkins, 2004

23. Tatum, W.O., Husain, A.M. Benbadis, S.R., Kaplan, P.W., Handbook of EEG Interpretation. Demos, 2007.

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24. Wyllie, E., Gupta, A., Lachhwani, D.K. (eds.) The Treatment of Epilepsy: Principles and Practice, 4th Ed. Lippincott Williams & Wilkins, 2006.

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