eeg chih ho chou department of neurology. eeg physiology distrubuted neuronal networks assure...
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EEG
Chih Ho ChouDepartment of neurology
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EEG Physiology
• Distrubuted neuronal networks assure correct functioning of the human brain.
• Inhibitory and excitatory feedforward and feedback processes are basic mechanisms
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Basic Interpretation
• Standard 10-20 or 10-10 system
• Awake and resting
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Montage
• Reference montage• Bipolar montage Anterior-posterior bipolar montage (double
banana montage) Transverse montage (E-montage) C-montage A1-A2 montage
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Calibration
• Time constant
• Sensitivity: 紀錄腦死時 sensitivity 需提高至
2 μV/mm
• Amplitude linearity
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Frequency filter
• 低頻截頻器 : 濾去過慢頻率之腦波 ( sweating…)
• 高頻截頻器 : 濾去過快頻率之腦波 (muscular artifacts…)
• Notch filter: 濾去 60 Hz 交流電
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Normal rhythms
rhythm (8-13 Hz occipital region, visual blocking)
rhythm (14-30 Hz) classification of frontal, widespread type, and posterior type (sometimes called fast alpha variant because of visual blocking)
• γ rhythm (>30), very low amplitude, technically difficult to study. Cognitive activity “dynamic”
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rhythm (sharp transient of sawtooth shape and of pasitive polarity in the pccopital regions, looking at image containing visual details. VEP)
• Mu rhythm (arch-shaped, 7-11Hz, paracentral area, blocked by voluntary or passive movements)
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Abnormal activities
• δ activity (4-7 Hz)
• Θ activity (<3 Hz)
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Artifacts
• Physiologic effects
1.from cardiovascular system
EKG artifact
pulse artifact
ballistocardiogram
2.respiratory artifact
3.sweating artifact
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4. EMG artifact
5. Eye movement artifact
6. glossokinetic artifact
7. body movement artifact
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• Mechanical artifact
electrode pop
60 Hz artifact
• Environmental artifact
static electricity
plug artifact
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Activation procedure
• Chemical activation hyperventilation drug: diazepam…• Input modification photic stimulation auditory somatic• State related to biological rhythm sleep sleep deprivation
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• 懷疑為 absence seizure, 一定要做hyperventilation
• 懷疑為 juventile myoclonic epilepsy, 一定要做 photic stimulation
• 懷疑為 temporal seizure, 一定要做 sleep EEG
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癲癇發作怎麼辦 ?
• 立即停止誘發• 保護病人為原則 不必硬塞東西到患者口中 不必強壓患者手腳 不必馬上送急診 , 除非是大發作癲癇重積
狀 態