SlideShare a Scribd company logo
normal awake eeg
LEARN PRACTICE ATLAS
READING THE BACKGROUND
When reading any EEG you start with the background, which reflects the overall health of a
person's brain and can be affected by many factors including acute illness, medications,
degenerative disease and normal state changes.
T H E R E A R E F O U R B A C K G R O U N D C O M P O N E N T S
Organization
&
AP Gradient
Posterior
Dominant
Rhythm
Variability
&
Reactivity
State
of
Consiousness
^
l e a r n i n g e e g
ORGANIZATION & AP GRADIENT
The organization of an EEG tracing refers, broadly, to how the waveforms appear across the
entirety of the page, and includes continuity, symmetry, and the anterior posterior gradient.
Continuity refers to the waveforms being uninterrupted by periods of flat or very attenuated
activity. Healthy children and adults should always have a continuous record, but early neonatal
tracings can show periods of discontinuity (this is discussed further in the neonatal and pediatric
section). Below are examples of both a continuous and discontinuous record.
The next component of organization is symmetry, in which both the left and right sides appear,
largely, the same in terms of both amplitude and frequency. Healthy EEGs should always be
symmetric, and intermittent or persistent asymmetries can arise from structural entities such as
tumors or bleeds. Changes in symmetry can be subtle, but note how on the asymmetric example
below how the left hemisphere has higher amplitude, slower delta activity compared to the right
side.
Continuous Discontinuous
^
In addition to symmetry and continuity, consider the anterior posterior gradient, in which
faster, lower amplitude frequencies are present towards the front of the brain while slower, higher
amplitude frequencies are found in the back of the brain. The AP gradient leads into the last
component of organization, the posterior dominant rhythm (PDR), discussed in the next section.
TEST YOURSELF
Symmetric Asymmetric
^
^
^
^
^
L E A R N I N G E E G U S E F U L L I N K S
Epilepsy Foundation
O T H E R
R E S O U R C E S ^
© David Valentine MD 2020
This site is meant for neurology
residents, epilepsy or clinical
neurophysiology fellows, and
EEG technicians. Please reach
out with questions, concerns or
suggestions; we're always
working to improve our content.
American Epilepsy Society
International League Against
Epilepsy
Americal Clinical
Neurophysiology Society
Rowan's Primer of EEG
Libenson's Practical Approach to
EEG
Niedermeyer's
Electroencephalography
Neonatal
Electroencephalography
^

More Related Content

Similar to The normal awake eeg and how to under ..

Epilepsy
EpilepsyEpilepsy
Epilepsy
Kouya71
 
Epilepsy
EpilepsyEpilepsy
چرخه های زیستی و خواب
چرخه های  زیستی  و خوابچرخه های  زیستی  و خواب
چرخه های زیستی و خواب
Zeinab alimadadi
 
Amplitude - INTEGRATED( aEEG)
Amplitude - INTEGRATED( aEEG)Amplitude - INTEGRATED( aEEG)
Amplitude - INTEGRATED( aEEG)
Tarek Kotb
 
Activation Proceedures in EEG.pptx
Activation Proceedures in EEG.pptxActivation Proceedures in EEG.pptx
Activation Proceedures in EEG.pptx
Pramod Krishnan
 
Hypothalamus physio.pptx
Hypothalamus physio.pptxHypothalamus physio.pptx
Hypothalamus physio.pptx
AbdulsamadAfolabi
 
Issues in brainmapping...The role of EEG in epileptic syndromes associated wi...
Issues in brainmapping...The role of EEG in epileptic syndromes associated wi...Issues in brainmapping...The role of EEG in epileptic syndromes associated wi...
Issues in brainmapping...The role of EEG in epileptic syndromes associated wi...
Professor Yasser Metwally
 
Coma and brain stem death
Coma and brain stem deathComa and brain stem death
Coma and brain stem death
Reed O'Brien
 
Neonatal seizures
Neonatal seizuresNeonatal seizures
Neonatal seizures
Gurajala venkatesh
 
Ataxia telangiecsta Anatomy Project
Ataxia telangiecsta Anatomy Project Ataxia telangiecsta Anatomy Project
Ataxia telangiecsta Anatomy Project
kellygaff
 
Status Epilepticus
Status EpilepticusStatus Epilepticus
Status Epilepticus
Jack Frost
 
Epilepsy in the Elderly.pptx
Epilepsy in the Elderly.pptxEpilepsy in the Elderly.pptx
Epilepsy in the Elderly.pptx
Pramod Krishnan
 
Epilepsy in the elderly
Epilepsy in the elderlyEpilepsy in the elderly
Epilepsy in the elderly
Pramod Krishnan
 
EEG Lecture 3: Artifacts and Benign EEG variants
EEG Lecture 3: Artifacts and Benign EEG variantsEEG Lecture 3: Artifacts and Benign EEG variants
EEG Lecture 3: Artifacts and Benign EEG variants
munnam37
 
Approaching the eeg
Approaching the eegApproaching the eeg
Approaching the eeg
rzgar hamed
 
EEG & Epilepsy syndromes report [Autosaved]
EEG & Epilepsy syndromes report [Autosaved]EEG & Epilepsy syndromes report [Autosaved]
EEG & Epilepsy syndromes report [Autosaved]
Margaret Mendez
 
Issues in brainmapping...EEG in dementias and hereditary encephalopathies
Issues in brainmapping...EEG in dementias and hereditary encephalopathiesIssues in brainmapping...EEG in dementias and hereditary encephalopathies
Issues in brainmapping...EEG in dementias and hereditary encephalopathies
Professor Yasser Metwally
 
Status epilepticus
Status epilepticusStatus epilepticus
Status epilepticus
BASIT ALI KHAN
 
Qavi ppt epileptic syndromes of neonate and infancy (2)
Qavi ppt epileptic syndromes of neonate and infancy (2)Qavi ppt epileptic syndromes of neonate and infancy (2)
Qavi ppt epileptic syndromes of neonate and infancy (2)
qavi786
 
Journal presentation on essential tremor
Journal presentation on essential tremorJournal presentation on essential tremor
Journal presentation on essential tremor
Ejaj Ahmed
 

Similar to The normal awake eeg and how to under .. (20)

Epilepsy
EpilepsyEpilepsy
Epilepsy
 
Epilepsy
EpilepsyEpilepsy
Epilepsy
 
چرخه های زیستی و خواب
چرخه های  زیستی  و خوابچرخه های  زیستی  و خواب
چرخه های زیستی و خواب
 
Amplitude - INTEGRATED( aEEG)
Amplitude - INTEGRATED( aEEG)Amplitude - INTEGRATED( aEEG)
Amplitude - INTEGRATED( aEEG)
 
Activation Proceedures in EEG.pptx
Activation Proceedures in EEG.pptxActivation Proceedures in EEG.pptx
Activation Proceedures in EEG.pptx
 
Hypothalamus physio.pptx
Hypothalamus physio.pptxHypothalamus physio.pptx
Hypothalamus physio.pptx
 
Issues in brainmapping...The role of EEG in epileptic syndromes associated wi...
Issues in brainmapping...The role of EEG in epileptic syndromes associated wi...Issues in brainmapping...The role of EEG in epileptic syndromes associated wi...
Issues in brainmapping...The role of EEG in epileptic syndromes associated wi...
 
Coma and brain stem death
Coma and brain stem deathComa and brain stem death
Coma and brain stem death
 
Neonatal seizures
Neonatal seizuresNeonatal seizures
Neonatal seizures
 
Ataxia telangiecsta Anatomy Project
Ataxia telangiecsta Anatomy Project Ataxia telangiecsta Anatomy Project
Ataxia telangiecsta Anatomy Project
 
Status Epilepticus
Status EpilepticusStatus Epilepticus
Status Epilepticus
 
Epilepsy in the Elderly.pptx
Epilepsy in the Elderly.pptxEpilepsy in the Elderly.pptx
Epilepsy in the Elderly.pptx
 
Epilepsy in the elderly
Epilepsy in the elderlyEpilepsy in the elderly
Epilepsy in the elderly
 
EEG Lecture 3: Artifacts and Benign EEG variants
EEG Lecture 3: Artifacts and Benign EEG variantsEEG Lecture 3: Artifacts and Benign EEG variants
EEG Lecture 3: Artifacts and Benign EEG variants
 
Approaching the eeg
Approaching the eegApproaching the eeg
Approaching the eeg
 
EEG & Epilepsy syndromes report [Autosaved]
EEG & Epilepsy syndromes report [Autosaved]EEG & Epilepsy syndromes report [Autosaved]
EEG & Epilepsy syndromes report [Autosaved]
 
Issues in brainmapping...EEG in dementias and hereditary encephalopathies
Issues in brainmapping...EEG in dementias and hereditary encephalopathiesIssues in brainmapping...EEG in dementias and hereditary encephalopathies
Issues in brainmapping...EEG in dementias and hereditary encephalopathies
 
Status epilepticus
Status epilepticusStatus epilepticus
Status epilepticus
 
Qavi ppt epileptic syndromes of neonate and infancy (2)
Qavi ppt epileptic syndromes of neonate and infancy (2)Qavi ppt epileptic syndromes of neonate and infancy (2)
Qavi ppt epileptic syndromes of neonate and infancy (2)
 
Journal presentation on essential tremor
Journal presentation on essential tremorJournal presentation on essential tremor
Journal presentation on essential tremor
 

Recently uploaded

Top 5 Benefits of Cancer Registry Services
Top 5 Benefits of Cancer Registry ServicesTop 5 Benefits of Cancer Registry Services
Top 5 Benefits of Cancer Registry Services
Cardiac Registry Support
 
nhs fpx 4000 assessment 4 analyzing a current health care problem or issue.pdf
nhs fpx 4000 assessment 4 analyzing a current health care problem or issue.pdfnhs fpx 4000 assessment 4 analyzing a current health care problem or issue.pdf
nhs fpx 4000 assessment 4 analyzing a current health care problem or issue.pdf
Carolyn Harker
 
Friendly Massage in Ajman - Malayali Kerala Spa Ajman
Friendly Massage in Ajman - Malayali Kerala Spa AjmanFriendly Massage in Ajman - Malayali Kerala Spa Ajman
Friendly Massage in Ajman - Malayali Kerala Spa Ajman
Malayali Kerala Spa Ajman
 
Assessing Large Language Models in the Context of Bioterrorism: An Epidemiolo...
Assessing Large Language Models in the Context of Bioterrorism: An Epidemiolo...Assessing Large Language Models in the Context of Bioterrorism: An Epidemiolo...
Assessing Large Language Models in the Context of Bioterrorism: An Epidemiolo...
AndrzejJarynowski
 
Fit to Fly PCR Covid Testing at our Clinic Near You
Fit to Fly PCR Covid Testing at our Clinic Near YouFit to Fly PCR Covid Testing at our Clinic Near You
Fit to Fly PCR Covid Testing at our Clinic Near You
NX Healthcare
 
Daughter's of Dr Ranjit Jagtap (Poulami & Aditi)
Daughter's of Dr Ranjit Jagtap (Poulami & Aditi)Daughter's of Dr Ranjit Jagtap (Poulami & Aditi)
Daughter's of Dr Ranjit Jagtap (Poulami & Aditi)
Aditi Jagtap Pune
 
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...
rightmanforbloodline
 
1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样
1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样
1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样
5sj7jxf7
 
Innovative Minds France's Most Impactful Healthcare Leaders.pdf
Innovative Minds France's Most Impactful Healthcare Leaders.pdfInnovative Minds France's Most Impactful Healthcare Leaders.pdf
Innovative Minds France's Most Impactful Healthcare Leaders.pdf
eurohealthleaders
 
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdf
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdfVEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdf
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdf
Vedanta A
 
Pneumothorax and role of Physiotherapy in it.
Pneumothorax and role of Physiotherapy in it.Pneumothorax and role of Physiotherapy in it.
Pneumothorax and role of Physiotherapy in it.
Vishal kr Thakur
 
nurs fpx 4050 assessment 4 final care coordination plan.pdf
nurs fpx 4050 assessment 4 final care coordination plan.pdfnurs fpx 4050 assessment 4 final care coordination plan.pdf
nurs fpx 4050 assessment 4 final care coordination plan.pdf
Carolyn Harker
 
Enhancing Hip and Knee Arthroplasty Precision with Preoperative CT and MRI Im...
Enhancing Hip and Knee Arthroplasty Precision with Preoperative CT and MRI Im...Enhancing Hip and Knee Arthroplasty Precision with Preoperative CT and MRI Im...
Enhancing Hip and Knee Arthroplasty Precision with Preoperative CT and MRI Im...
Pristyn Care Reviews
 
Sexual Disorders.gender identity disorderspptx
Sexual Disorders.gender identity  disorderspptxSexual Disorders.gender identity  disorderspptx
Sexual Disorders.gender identity disorderspptx
Pupayumnam1
 
NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPT
NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPTNURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPT
NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPT
blessyjannu21
 
FACIAL NERVE
FACIAL NERVEFACIAL NERVE
FACIAL NERVE
aditigupta1117
 
U Part Wigs_ A Natural Look with Minimal Effort Jokerwigs.in.pdf
U Part Wigs_ A Natural Look with Minimal Effort Jokerwigs.in.pdfU Part Wigs_ A Natural Look with Minimal Effort Jokerwigs.in.pdf
U Part Wigs_ A Natural Look with Minimal Effort Jokerwigs.in.pdf
Jokerwigs arts and craft
 
一比一原版(USF毕业证)旧金山大学毕业证如何办理
一比一原版(USF毕业证)旧金山大学毕业证如何办理一比一原版(USF毕业证)旧金山大学毕业证如何办理
一比一原版(USF毕业证)旧金山大学毕业证如何办理
40fortunate
 
India Medical Devices Market: Size, Share, and In-Depth Competitive Analysis ...
India Medical Devices Market: Size, Share, and In-Depth Competitive Analysis ...India Medical Devices Market: Size, Share, and In-Depth Competitive Analysis ...
India Medical Devices Market: Size, Share, and In-Depth Competitive Analysis ...
Kumar Satyam
 
The Ultimate Guide in Setting Up Market Research System in Health-Tech
The Ultimate Guide in Setting Up Market Research System in Health-TechThe Ultimate Guide in Setting Up Market Research System in Health-Tech
The Ultimate Guide in Setting Up Market Research System in Health-Tech
Gokul Rangarajan
 

Recently uploaded (20)

Top 5 Benefits of Cancer Registry Services
Top 5 Benefits of Cancer Registry ServicesTop 5 Benefits of Cancer Registry Services
Top 5 Benefits of Cancer Registry Services
 
nhs fpx 4000 assessment 4 analyzing a current health care problem or issue.pdf
nhs fpx 4000 assessment 4 analyzing a current health care problem or issue.pdfnhs fpx 4000 assessment 4 analyzing a current health care problem or issue.pdf
nhs fpx 4000 assessment 4 analyzing a current health care problem or issue.pdf
 
Friendly Massage in Ajman - Malayali Kerala Spa Ajman
Friendly Massage in Ajman - Malayali Kerala Spa AjmanFriendly Massage in Ajman - Malayali Kerala Spa Ajman
Friendly Massage in Ajman - Malayali Kerala Spa Ajman
 
Assessing Large Language Models in the Context of Bioterrorism: An Epidemiolo...
Assessing Large Language Models in the Context of Bioterrorism: An Epidemiolo...Assessing Large Language Models in the Context of Bioterrorism: An Epidemiolo...
Assessing Large Language Models in the Context of Bioterrorism: An Epidemiolo...
 
Fit to Fly PCR Covid Testing at our Clinic Near You
Fit to Fly PCR Covid Testing at our Clinic Near YouFit to Fly PCR Covid Testing at our Clinic Near You
Fit to Fly PCR Covid Testing at our Clinic Near You
 
Daughter's of Dr Ranjit Jagtap (Poulami & Aditi)
Daughter's of Dr Ranjit Jagtap (Poulami & Aditi)Daughter's of Dr Ranjit Jagtap (Poulami & Aditi)
Daughter's of Dr Ranjit Jagtap (Poulami & Aditi)
 
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...
 
1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样
1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样
1比1制作(uofm毕业证书)美国密歇根大学毕业证学位证书原版一模一样
 
Innovative Minds France's Most Impactful Healthcare Leaders.pdf
Innovative Minds France's Most Impactful Healthcare Leaders.pdfInnovative Minds France's Most Impactful Healthcare Leaders.pdf
Innovative Minds France's Most Impactful Healthcare Leaders.pdf
 
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdf
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdfVEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdf
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdf
 
Pneumothorax and role of Physiotherapy in it.
Pneumothorax and role of Physiotherapy in it.Pneumothorax and role of Physiotherapy in it.
Pneumothorax and role of Physiotherapy in it.
 
nurs fpx 4050 assessment 4 final care coordination plan.pdf
nurs fpx 4050 assessment 4 final care coordination plan.pdfnurs fpx 4050 assessment 4 final care coordination plan.pdf
nurs fpx 4050 assessment 4 final care coordination plan.pdf
 
Enhancing Hip and Knee Arthroplasty Precision with Preoperative CT and MRI Im...
Enhancing Hip and Knee Arthroplasty Precision with Preoperative CT and MRI Im...Enhancing Hip and Knee Arthroplasty Precision with Preoperative CT and MRI Im...
Enhancing Hip and Knee Arthroplasty Precision with Preoperative CT and MRI Im...
 
Sexual Disorders.gender identity disorderspptx
Sexual Disorders.gender identity  disorderspptxSexual Disorders.gender identity  disorderspptx
Sexual Disorders.gender identity disorderspptx
 
NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPT
NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPTNURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPT
NURSING MANAGEMENT OF PATIENT WITH EMPHYSEMA .PPT
 
FACIAL NERVE
FACIAL NERVEFACIAL NERVE
FACIAL NERVE
 
U Part Wigs_ A Natural Look with Minimal Effort Jokerwigs.in.pdf
U Part Wigs_ A Natural Look with Minimal Effort Jokerwigs.in.pdfU Part Wigs_ A Natural Look with Minimal Effort Jokerwigs.in.pdf
U Part Wigs_ A Natural Look with Minimal Effort Jokerwigs.in.pdf
 
一比一原版(USF毕业证)旧金山大学毕业证如何办理
一比一原版(USF毕业证)旧金山大学毕业证如何办理一比一原版(USF毕业证)旧金山大学毕业证如何办理
一比一原版(USF毕业证)旧金山大学毕业证如何办理
 
India Medical Devices Market: Size, Share, and In-Depth Competitive Analysis ...
India Medical Devices Market: Size, Share, and In-Depth Competitive Analysis ...India Medical Devices Market: Size, Share, and In-Depth Competitive Analysis ...
India Medical Devices Market: Size, Share, and In-Depth Competitive Analysis ...
 
The Ultimate Guide in Setting Up Market Research System in Health-Tech
The Ultimate Guide in Setting Up Market Research System in Health-TechThe Ultimate Guide in Setting Up Market Research System in Health-Tech
The Ultimate Guide in Setting Up Market Research System in Health-Tech
 

The normal awake eeg and how to under ..

  • 1. normal awake eeg LEARN PRACTICE ATLAS READING THE BACKGROUND When reading any EEG you start with the background, which reflects the overall health of a person's brain and can be affected by many factors including acute illness, medications, degenerative disease and normal state changes. T H E R E A R E F O U R B A C K G R O U N D C O M P O N E N T S Organization & AP Gradient Posterior Dominant Rhythm Variability & Reactivity State of Consiousness ^ l e a r n i n g e e g
  • 2. ORGANIZATION & AP GRADIENT The organization of an EEG tracing refers, broadly, to how the waveforms appear across the entirety of the page, and includes continuity, symmetry, and the anterior posterior gradient. Continuity refers to the waveforms being uninterrupted by periods of flat or very attenuated activity. Healthy children and adults should always have a continuous record, but early neonatal tracings can show periods of discontinuity (this is discussed further in the neonatal and pediatric section). Below are examples of both a continuous and discontinuous record. The next component of organization is symmetry, in which both the left and right sides appear, largely, the same in terms of both amplitude and frequency. Healthy EEGs should always be symmetric, and intermittent or persistent asymmetries can arise from structural entities such as tumors or bleeds. Changes in symmetry can be subtle, but note how on the asymmetric example below how the left hemisphere has higher amplitude, slower delta activity compared to the right side. Continuous Discontinuous ^
  • 3. In addition to symmetry and continuity, consider the anterior posterior gradient, in which faster, lower amplitude frequencies are present towards the front of the brain while slower, higher amplitude frequencies are found in the back of the brain. The AP gradient leads into the last component of organization, the posterior dominant rhythm (PDR), discussed in the next section. TEST YOURSELF Symmetric Asymmetric ^
  • 4. ^
  • 5. ^
  • 6. ^
  • 7. ^
  • 8. L E A R N I N G E E G U S E F U L L I N K S Epilepsy Foundation O T H E R R E S O U R C E S ^
  • 9. © David Valentine MD 2020 This site is meant for neurology residents, epilepsy or clinical neurophysiology fellows, and EEG technicians. Please reach out with questions, concerns or suggestions; we're always working to improve our content. American Epilepsy Society International League Against Epilepsy Americal Clinical Neurophysiology Society Rowan's Primer of EEG Libenson's Practical Approach to EEG Niedermeyer's Electroencephalography Neonatal Electroencephalography ^