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Normal Neonatal EEG
- 1. Normal Neonatal EEG Lalit Bansal, MD 04/26/2018
- 2. What is the least number of electrodes for neonatal scalp recording?
- 3. M2 10-20 SYSTEM M1 RL CZC3 C4 O1 O2 T7 T8 AF4AF3 9 recording electrodes 1 ground electrode 2 reference electrodes Biological signal electrodes
- 4. What age is relevant for EEG interpretation?
- 7. EYE CLOSED FOR > 30 SECONDS SLEEP YESNOAWAKE When can you tell just by looking if a neonate is sleep or awake?
- 8. When can you tell just by looking if a neonate is sleep or awake? EYE CLOSED FOR > 30 SECONDS SLEEP YESNOAWAKE
- 9. Which sleep stages is best to evaluate the neonatal EEG?
- 10. EYE CLOSED FOR > 30 SECONDS SLEEP YESNOAWAKE ACTIVE QUIET INDETERMINATE
- 11. EYE CLOSED FOR > 30 SECONDS SLEEP YESNOAWAKE ACTIVE QUIET INDETERMINATE
- 12. What parameters are used to distinguish the different sleep stages in neonates?
- 13. Rapid eye movements Chin EMG Respiratory rate Limb movements Parameters
- 14. EYE CLOSED FOR > 30 SECONDS SLEEP REGULARIRREGULAR CHIN EMG LOW HIGH INDETERMINATE: NEITHER OF THEM LIMB MOVEMENTS YES YESNOAWAKE YES NO RESPIRATORY RATE RAPID EYE MOVEMENTS NO QUIETACTIVE
- 15. CONCEPTIONAL AGE THAT PARAMETERS BECOME A RELIABLE MEASURE OF STATES (PARMELEE 72) ACTIVE 3/4 QUIET 3/4 REGULARIRREGULAR CHIN EMG LOW HIGH LIMB MOVEMENTS YES YES NO NO RESPIRATORY RATE RAPID EYE MOVEMENTS CA WEEKS 28 32 40 31
- 16. SLEEP TIME 50 25 75 % QUIET 29 33 35 37 39 41 43 45 CONCEPTIONAL AGE W27 31 44 INDETERMINATE ACTIVE
- 17. SLEEP/AWAKE CYCLE CONCEPTIONAL AGE: 40 WEEKS Active sleep onset: 80%
- 18. SLEEP/AWAKE CYCLE CONCEPTIONAL AGE: 46 WEEKS Quiet sleep onset: 80%
- 19. 21 Conceptual age (weeks) 24 First EEG recorded brain waves
- 20. BACKGROUND INTERHEMISPHERIC AMPLITUDE SYMMETRY INTERHEMISPHERIC SYNCHRONY REACTIVITY CONTINUITY PATTERN VARIABILITY
- 24. SYNCHRONY During a chosen 5 minutes of a tracing all burst from both hemispheres should start and end within 2 seconds of each other!
- 25. SYNCHRONOUS DEVELOPMENT OF BILATERAL SYNCHRONY ASYNCHRONOUS AS QS AW WEEKS 28 29 30 31 32 33 34 35 3627 37
- 26. SYNCHRONOUS DEVELOPMENT OF BILATERAL SYNCHRONY (Lombroso) ASYNCHRONOUS AS QS IS WEEKS 28 29 30 31 32 33 34 35 3627 37
- 27. DEVELOPMENT OF BILATERAL SYNCHRONY WEEKS 36 37 38 39 40 41 42 43 44 AS QS AW SYNCHRONOUSASYNCHRONOUS
- 28. SYNCHRONOUS DEVELOPMENT OF BILATERAL SYNCHRONY (Mizrahi) ASYNCHRONOUS AS QS AW WEEKS 28 29 30 31 32 33 34 35 3627 37 38 39 4026
- 29. Quiet sleep Weeks CA Synchrony 40-42 100% 37-39 80-100% 35-36 70-85% 33-34 60-80% 31-32 50-70%
- 30. INTERHEMISPHERIC SYNCHRONY 100% asymmetry after 31 W CA is abnormal
- 31. INTERHEMISPHERIC SYNCHRONY < 100% at 40 W CA is abnormal
- 32. Continuos EEG No periods of voltage attenuation of less than 25 mV lasting longer than 2 seconds
- 33. Discontinuous EEG Periods of voltage attenuation of less than 25 mV lasting longer than 2 seconds
- 34. CONTINUOSDISCONTINUOUS AS QS AW WEEKS 28 29 30 31 32 33 34 35 3627 37 DEVELOPMENT OF BILATERAL CONTINUITY (L & L)
- 35. AS QS AW WEEKS 36 37 38 39 40 41 42 43 44 CONTINUOSDISCONTINUOUS DEVELOPMENT OF BILATERAL CONTINUITY (L & L)
- 36. Normal discontinuity Conceptional age Interburst Maximal duration (seconds) Minimal amplitude (mV) <30 35 <25 30-33 20 <25 34-36 10 25 37-40 6 >25 2.5 - 3 SD
- 37. REACTIVITY (SOME CHANGE IN THE ONGOING EEG BACKGROUND) TO PAIN, PHOTIC, NOISE FLATTENING INCREASED AMPLITUDE
- 38. NO REACTIVITY IN A TRACING CA WEEKS 28 29 30 31 32 33 34 35 3627 37 FLATTENING OR INCREASED AMPLITUDE NORMAL ABNORMAL ?
- 39. BACKGROUND L OW VOLTAGE IRREGULAR MIXED VOLTAGE TRACÉ DISCONTINU ACTIVITE MOYENNE TRACÉ ALTERNANT HIGH VOLTAGE S LOW
- 40. TRACÉ DISCONTINU Physiologic discontinuous pattern bursts of high voltage (50-300 µV pp) activity that are regularly interrupted by low voltage interburst periods (< 25 µV pp) Predominates <28 Weeks First in waking then in active sleep Periods of discontinuity is per GA
- 41. C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 50 mV 1 s TRACÉ DISCONTINU 100-150 mV 0.5-3 Hz
- 42. MIXED VOLTAGE PATTERN CONTINUOUS FREQUENCY: 0.5-7 Hz FIRST APPEARS: 30 WEEKS 20-50 mV INTERMIXED WAVES 100-150 mV
- 44. MINIMALLY DISCONTINUOUS FREQUENCY: 0.5-7 Hz FIRST APPEARS: 36 WEEKS Seen during awake and active sleep 20-50 mV INTERMIXED WAVES 100-150 mV ACTIVITE MOYENNE
- 45. C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 50 mV 1 s ACTIVITE MOYENNE 20-50 mV 100-150 mV 0.5-7 HzCONTINUOUS DIFFUSE
- 46. C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 50 mV 1 s LOW VOLTAGE IRREGULAR 20-30 mV > 38 weeks Waking/active sleep 4-12 Hz CONTINUOUS
- 47. C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 50 mV 1 s BURST INTER-BURST TRACE ALTERNANT Quiet sleep 37 weeks TDTA
- 48. SHORTEST DURATION OF THE BURST IN NEUROLOGICALLY NORMAL CONTROL NEONATES Normal burst in trace alternant are > 5 sec 37 38 39 40 41 42 43 44 2 4 6 8 10 12 sec CA WEEKS LONG IS GOOD; SHORT IS BAD!
- 49. C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 HIGH VOLTAGE SLOW 50 mV 1 s 100-150 mV0.5-4 HzCONTINUOUS Quiet Sleep >38 weeks
- 50. 29 31 33 35 37 39 41 43 45 CONCEPTIONAL AGE W SLEEP TIME LVI & AM 50 27 25 75 % ACTIVE QUIET INDETERMINATE
- 51. 29 31 33 35 37 39 41 43 45 CONCEPTIONAL AGE W SLEEP TIME HVS & TA 50 27 25 75 % ACTIVE QUIET INDETERMINATE
- 52. AVERAGE DURATION OF TA & HVS PERIODS IN NEUROLOGICALLY NORMAL CONTROL NEONATES DURING QUIET SLEEP 0 5 10 15 20 25 30 32 33 34 35 36 37 38 39 40 41 42 43 44 45 M I N U T E S CA WEEKS
- 53. 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 EEG BACKGROUND WEEKS (CA) TD TD M TD M TA AM LVI HVS TD – Trace Discontinu M – Mixed Voltage AM – Activite Moyenne LVI – Low Voltage Irregular HVS – High Voltage Slow TA – Trace Alternant-
- 54. CZC3 C4 O1 O2 M1 M2 T3 T4 Fp2Fp1 FRONTAL SHARP TRANSIENTS FULL TERM (ENCOCHES) VERY PREMATURE (HIGH AMPLITUDE) PREMATURE (LOW AMPLITUDE) ANTERIOR DELTA RUN (SLOW DYSRHYTHMIA)
- 55. C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 36CA: 33302724 W39 42 50 mV 1 s TD FRONTAL SHARP TRANSIENTS (HIGH AMPLITUDE)
- 56. C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 36CA: 2724 W39 423330 50 mV 1 s TD M FRONTAL SHARPS TRANSIENTS (LOW AMPLITUDE)
- 57. FRONTAL SHARPS TRANSIENTS (ENCOCHES) C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 CA: 30 W38 40 423432 36 50 mV 1 s LVI TA
- 58. C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 ANTERIOR DELTA RUN (SLOW DYSRYTHMIA) 44CA: 403634302622 W 50 mV 1 s AM
- 59. C3-O1 F1-C3 50 mV 1 ms FRONTAL ACTIVITIES 36CA: 2724 W33 3930 42
- 60. 38CA: 36343230 W QS IS AS AW 40 42 AS QS FRONTAL SHARPS TRANSIENTS (ENCOCHES)
- 61. FRONTAL SHARPS TRANSIENTS (ENCOCHES) C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 CA: 30 W38 40 423432 36 50 mV 1 s LVI TA ENCOCHES FRONTALES SYNCHRONOUS BILATERAL FIRST NEGATIVE SPIKE LESS AMPLITUDE THAN THE POSITIVE COMPONENT FIRST NEG. WAVE: > 70 ms SYMMETRICAL
- 62. WHEN ARE ENCOCHES FRONTALES PATHOLOGICAL? FIRST NEGATIVE COMPONENT HAS HIGHER AMPLITUDE THAN THE POSITIVE COMPONENT NORMAL ABNORMAL
- 63. DURATION OF FIRST NEGATIVE SPINE IS LESS THAN 70 ms FROM THE PROJECTED BASED NORMAL ABNORMAL WHEN ARE ENCOCHES FRONTALES PATHOLOGICAL?
- 64. ASYMMETRY OVER 50% R LR L NORMAL ABNORMAL WHEN ARE ENCOCHES FRONTALES PATHOLOGICAL?
- 65. R LR L NORMAL ABNORMAL ASYNCHRONY OVER 50% AFTER 36 WEEKS WHEN ARE ENCOCHES FRONTALES PATHOLOGICAL?
- 66. R LR L NORMAL ABNORMAL UNILATERAL WHEN ARE ENCOCHES FRONTALES PATHOLOGICAL?
- 67. CZ O1 O2 M1 M2 T3 T4 Fp2Fp1 C3 C4 ROLANDIC DIPS ROLANDIC SHARP DELTA BRUSH (CENTRAL)
- 68. ROLANDIC DIPS C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 CA: 24 W39 4230 33 3627 50 mV 1 s TD TA
- 69. ROLANDIC SHARP C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 CA: 2724 W39 4230 33 36 50 mV 1 s TA TD SHORT DURATION SYMMETRICAL OR ASYMMETRICAL
- 70. DELTA BRUSH CENTRAL C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 50 mV 1 s CA: 24 W39 4230 33 3627TD
- 71. DELTA BRUSHES 28 30 32 34 36 38 40 42 44 WEEKS CA 10 s 2 6 10 AS Brush activity: fast before 32 weeks 18 to 22 Hz
- 72. ROLANDIC DIPS CA: 24 W39 4230 33 3627 ROLANDIC SHARP CA: 2724 W39 4230 33 36 DELTA BRUSH (CENTRAL) CA: 24 W39 4230 33 3627
- 73. CZ O1 O2 M1 M2 Fp2Fp1 C3 C4 T4T3 SMALL TEMPORAL POSITIVE TEMPORAL NEGATIVE SHARP TEMPORAL SAWTOOTH (Theta burst/Alpha burst) RHYTHMIC 3 HZ ACTIVITY
- 74. SMALL TEMPORAL POSITIVE C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 50 mV 1 s LOW VOLTAGE NO EVOLUTION CA: 24 W39 4230 33 3627TD
- 75. TEMPORAL SAWTOOTH (Theta Burst) C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 CA: 24 W39 4230 33 3627 50 mV 1 s TD
- 76. TEMPORAL SAWTOOTH (ALPHA Burst) C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 CA: 24 W39 4230 33 3627TD 50 mV 1 s
- 77. RHYTHMIC 3 HZ ACTIVITY C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 CA: 24 W39 4230 33 3627 50 mV 1 s TD
- 78. TEMPORAL NEGATIVE SHARP C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 CA: 2724 W39 4230 33 36 50 mV 1 s TD
- 79. CZC3 C4 M1 M2 T3 T4 Fp2Fp1 O1 O2 OCCIPITAL NEGATIVE SHARPS OCCIPITAL DELTA BRIEF OCCIPITAL THETA BURST DELTA BRUSH (POSTERIOR)
- 80. OCCIPITAL NEGATIVE SHARPS C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 36CA: 33302724 W39 42 50 mV 1 s TD
- 81. C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 CZ-A1 50 mV 1 s OCCIPITAL NEGATIVE SHARPS 36CA: 33302724 W39 42TD
- 82. OCCIPITAL DELTA C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 36CA: 2724 W39 423330 50 mV 1 ms M
- 83. BRIEF OCCIPITAL THETA BURST C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 36CA: 33302724 W39 42 50 mV 1 s TA
- 84. CA: 2724 W4230 33 36 39 TA ,TD LVI DELTA BRUSH (POSTERIOR)
- 85. DELTA BRUSHES 28 30 32 34 36 38 40 42 44 WEEKS CA 10 s 2 6 10 QS Brush activity: slow after 32 weeks 8 to 12 Hz
- 86. DELTA BRUSHES 28 30 32 34 36 38 40 42 44 WEEKS CA 10 s 2 6 10 QS AS
- 87. CA WEEKS 28 29 30 31 32 33 34 35 3627 37 Active sleep Quiet sleep DELTA BRUSHES Brush: 18-22 Brush: 8-12 Central Occipitotemporal
- 88. CZC3 C4 M1 M2 T3 T4 Fp2Fp1 O1 O2 DIFFUSE ATTENUATION TO STIMULATION RHYTHMIC THETA
- 89. 38 DIFFUSE ATTENUATION TO STIMULATION C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 CA: 36343230 W QS IS AS AW 40 42 50 mV 1 s
- 91. RHYTHMIC THETA C3-O1 F1-C3 F2-C4 C4-O2 F1-T3 T3-O1 F2-T4 T4-O2 C3-CZ CZ-C4 CA: 2724 W39 4230 33 36 ANY TIME 50 mV 1 s TD M
- 92. 22-23
- 93. O – t & D 22-23 sharps
- 94. O – t & D 22-23 sharps FST (High amp.)
- 95. O – t & D 22-23 sharps FST (High amp.)
- 96. O – t & D 24-26 sharps FST (High amp.)
- 97. O – t & D 24-26 Rolandic dips Rolandic dips sharps FST (High amp.)
- 98. O – t & D 24-26 Rolandic dips Rolandic dips Small T + Small T + sharps FST (High amp.)
- 99. O – t & D 24-26 Rolandic dips Rolandic dips Small T + Small T + (t)T sawtooth (t)T sawtooth sharps FST (High amp.)
- 100. O – t & D 24-26 Rolandic dips Rolandic dips Small T + Small T + (t)T sawtooth (t)T sawtooth sharps FST (High amp.)
- 101. O – t & D 27-28 Rolandic dips Rolandic dips Small T + Small T + (t)T sawtooth (t)T sawtooth sharps FST (High amp.)
- 102. O – t & D 27-28 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + (t)T sawtooth (t)T sawtooth sharps
- 103. O – t & D 27-28 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. sharps
- 104. O – t & D 27-28 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. T - sharp T - sharp sharps
- 105. O – t & D 27-28 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps(t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. T - sharp T - sharp sharps
- 106. O – t & D 27-28 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. T - sharp T - sharp sharps
- 107. O – t & D 27-28 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. T - sharp T - sharp sharps Occipital D
- 108. O – t & D 27-28 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. T - sharp T - sharp sharps Occipital D
- 109. O – t & D 29-30 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. T - sharp T - sharp sharps Occipital D
- 110. O – t & D 29-30 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. T - sharp T - sharp sharps Occipital D
- 111. O – t & D 29-30 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. FST (Low amp.) sharps Occipital D T - sharp T - sharp
- 112. O – t & D 29-30 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. FST (Low amp.) sharps Occipital D T - sharp T - sharp (a) (a)
- 113. O – t & D 29-30 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. FST (Low amp.) sharps Occipital D DB T - sharp T - sharp (a) (a)
- 114. O – t & D 29-30 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. FST (Low amp.) sharps Occipital D DB T - sharp T - sharp (a) (a)
- 115. O – t & D 31-33 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. FST (Low amp.) sharps Occipital D DB T - sharp T - sharp (a) (a)
- 116. O – t & D 31-33 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. FST (Low amp.) sharps Occipital D DB T - sharp T - sharp (a) (a)
- 117. O – t & D 31-33 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. FST (Low amp.) sharps Occipital D (a) (a) DB T - sharp T - sharp
- 118. O – t & D 31-33 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. FST (Low amp.) sharps Occipital D (a) (a) DB T - sharp T - sharp
- 119. O – t & D 34-35 FST (High amp.) Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. FST (Low amp.) sharps Occipital D (a) (a) DB T - sharp T - sharp
- 120. O – t & D 34-35 Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (t)T sawtooth (t)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. FST (Low amp.) sharps Occipital D (a) (a) DB T - sharp T - sharp
- 121. O – t & D 34-35 Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB Rhythmic 3 Hz act. Rhythmic 3 Hz act. FST (Low amp.) sharps Occipital D (a) (a) DB T - sharp T - sharp
- 122. O – t & D 34-35 Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (a)T sawtooth (a)T sawtooth Rhythmic 3 Hz act. Rhythmic 3 Hz act. FST (Low amp.) sharps Occipital D DB T - sharp T - sharp
- 123. O – t & D 34-35 Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (a)T sawtooth (a)T sawtooth FST (Low amp.) sharps Occipital D DB T - sharp T - sharp
- 124. O – t & D 34-35 Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (a)T sawtooth (a)T sawtooth FST (Low amp.) sharps Occipital D DB T - sharp T - sharp
- 125. O D 34-35 Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (a)T sawtooth (a)T sawtooth FST (Low amp.) sharps Occipital D DB T - sharp T - sharp
- 126. O D 34-35 Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (a)T sawtooth (a)T sawtooth FST (Low amp.) sharps Occipital D DB T - sharp T - sharp
- 127. O D 34-35 Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (a)T sawtooth (a)T sawtooth FST (Low amp.) sharps DB T - sharp T - sharp
- 128. O D 34-35 Rolandic dips Rolandic dips Small T + Small T + Rolandic sharps Rolandic sharps DB (a)T sawtooth (a)T sawtooth FST (Low amp.) sharps DB Encouche T - sharp T - sharp
- 129. O D 34-35 Rolandic dips Rolandic dips Rolandic sharps Rolandic sharps DB (a)T sawtooth (a)T sawtooth FST (Low amp.) sharps DB Encouche T - sharp T - sharp
- 130. O D 34-35 Rolandic dips Rolandic dips Rolandic sharps Rolandic sharps DB FST (Low amp.) sharps DB Encouche (a)T sawtooth (a)T sawtooth T - sharp T - sharp
- 131. O D 36-37 Rolandic dips Rolandic dips Rolandic sharps Rolandic sharps DB FST (Low amp.) sharps DB Encouche (a)T sawtooth (a)T sawtooth T - sharp T - sharp
- 132. O D 36-37 Rolandic dips Rolandic dips Rolandic sharps Rolandic sharps DB FST (Low amp.) sharps DB Encouche (a)T sawtooth (a)T sawtooth T - sharp T - sharp
- 133. O D 36-37 Rolandic dips Rolandic dips Rolandic sharps Rolandic sharps DB FST (Low amp.) sharps DB Encouche Slow dysrhythmia (a)T sawtooth (a)T sawtooth T - sharp T - sharp
- 134. O D 36-37 Rolandic dips Rolandic dips Rolandic sharps Rolandic sharps FST (Low amp.) sharps DB Encouche Slow dysrhythmia (a)T sawtooth (a)T sawtooth T - sharp T - sharp
- 135. O D 36-37 Rolandic dips Rolandic dips Rolandic sharps Rolandic sharps FST (Low amp.) sharps DB Encouche Slow dysrhythmia Brief O burst (a)T sawtooth (a)T sawtooth T - sharp T - sharp
- 136. O D 36-37 Rolandic dips Rolandic dips Rolandic sharps Rolandic sharps FST (Low amp.) sharps DB Encouche Slow dysrhythmia Post- stimulus depressionBrief O burst (a)T sawtooth (a)T sawtooth T - sharp T - sharp
- 137. O D 36-37 Rolandic dips Rolandic dips Rolandic sharps Rolandic sharps FST (Low amp.) sharps DB Encouche Slow dysrhythmia Post- stimulus depressionBrief O burst T - sharp T - sharp
- 138. O D 36-37 Rolandic dips Rolandic dips Rolandic sharps Rolandic sharps FST (Low amp.) sharps DB Encouche Slow dysrhythmia Post- stimulus depressionBrief O burst sharp T - sharp
- 139. O D 38-40 Rolandic dips Rolandic dips Rolandic sharps Rolandic sharps FST (Low amp.) sharps DB Encouche Slow dysrhythmia Post- stimulus depressionBrief O burst sharp T - sharp
- 140. O D 38-40 Rolandic dips Rolandic dips Rolandic sharps Rolandic sharps sharps DB Encouche Slow dysrhythmia Post- stimulus depressionBrief O burst sharp T - sharp
- 141. O D 38-40 Rolandic sharps Rolandic sharps sharps DB Encouche Slow dysrhythmia Post- stimulus depressionBrief O burst sharp T - sharp
- 142. 38-40 Rolandic sharps Rolandic sharps DB Encouche Slow dysrhythmia Post- stimulus depressionBrief O burst sharp T - sharp
- 143. 38-40 Rolandic sharps Rolandic sharps DB Encouche Slow dysrhythmia Post- stimulus depressionBrief O burst sharp T - sharp
- 144. 41-44 Rolandic sharps Rolandic sharps DB Encouche Slow dysrhythmia Post- stimulus depressionBrief O burst sharp T - sharp
- 145. 41-44 Rolandic sharps Rolandic sharps DB Encouche Slow dysrhythmia Post- stimulus depressionBrief O burst sharp T - sharp
- 146. 41-44 DB Encouche Slow dysrhythmia Post- stimulus depressionBrief O burst sharp T - sharp
- 149. How many weeks can EEG age be behind chronological age and still be considered normal?
- 150. < 2 weeks! An EEG age more than 2 weeks behind chronological age is abnormal!
- 151. Sustain arousal Not as high Sleep stages More variability Duration of QS Longer Duration of AS Longer Burst in TA Longer GA 40 GA 28 CA: 41 weeks
- 152. Eye movements Less Clonic chin movements PresentAbsent Heart rate Faster Respiratory rate Higher GA 40 + LA 1 GA 28 + LA 23 CA: 41 weeks
- 153. MOST INTERICTAL SPIKES IN NEONATES ARE SURFACE NEGATIVE BUT SO ARE THE NORMAL NON-ICTAL SHARP WAVES. BUT WHEN SHARP WAVES HAVE POSITIVE FILED THE LIKELIHOOD THEY ARE INTERICTAL EPILEPTIFORM IS HIGHER CHARACTERISTIC OF INTERICTAL EPILEPTIFORM WAVEFORMS
- 154. What are the pattern alledgedly linked to specific diseases?
- 164. EEG A – NH3 = 1445 micromol/L B – NH3 = 355 micromol/L Duration of interburst interval improves with treatment Ornithine Transcarbamylase Deficiency (Congenital Hyperammonemia Type II)
- 165. Thank you