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Module 1: Introduction to EEG (ICETAP)

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ICETAP EEG

on 11 January 2015

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Transcript of Module 1: Introduction to EEG (ICETAP)

Module 1: Introduction to EEG
Answer: C
Answer: C
1. Why EEG in anesthesia?
2. History of EEG
3. EEG Montage
The following 3 ECG leads are potentially helpful for what?

A. I, II and III for right bundle branch block

B. I, V, and VI for mild hypokalemia

C. II, IV and V for rhythm & ischemia

D. I, IV and V for RV hypertrophy

E. Don’t know

The following 3 ECG leads are potentially helpful for what?

A. I, II and III for right bundle branch block

B. I, V, and VI for mild hypokalemia

C. II, IV and V for rhythm & ischemia

D. I, IV and V for RV hypertrophy

E. Don’t know


The Motivation for the EEG

1.     The brain is a primary target organ of GA

2.     The field has not established a standard monitor for the brain.

3.     The EEG provides useful information during anesthesia, including surrogacy of unawareness.

4.     Training in EEG interpretation is unstructured and truncated in many training programs.

5.     EEG plug and play modules are available with most intraoperative monitors.

Which montage do you use
when you use a BIS?
What is Montage?

The placement of the electrodes.

Bipolar montage: two electrodes per channel; a reference electrode for each channel.

Referential montage: a common reference electrode for all the channels.

http://www.medicine.mcgill.ca/physio/vlab/biomed_signals/eeg_n.htm



4. EEG Waveforms
Beta (12-30+ Hz.)

Seen on both sides in symmetrical distribution & is most evident frontally.
Accentuated by sedative-hypnotic drugs especially benzodiazepines & the barbiturates.
May be absent or reduced in areas of cortical damage.
A normal rhythm.
Dominant rhythm in patients who are alert / anxious / have eyes open.

http://www.medicine.mcgill.ca/physio/vlab/biomed_signals/eeg_n.htm

Alpha (8-12 Hz.)

Best seen in posterior regions, being higher in amplitude on the dominant side.
Appears when closing the eyes & relaxing, & disappears when opening the eyes or alerting by any mechanism (thinking, calculating).
Major rhythm in normal relaxed adults.
Present during most of life especially after the 13th yr

http://www.medicine.mcgill.ca/physio/vlab/biomed_signals/eeg_n.htm

Theta (4-8 Hz.)

Normal in children up to 13 years & in sleep but abnormal in awake adults

Manifestation of focal subcortical lesions

Generalized distribution in diffuse disorders such as metabolic encephalopathy / some instances of hydrocephalus.

http://www.medicine.mcgill.ca/physio/vlab/biomed_signals/eeg_n.htm

Delta (0-4 Hz.)

Dominant rhythm in infants up to 1 yr & in stages 3 and 4 of sleep.
Focal with subcortical lesions.
General distribution with diffuse lesions, metabolic encephalopathy hydrocephalus or deep midline lesions.
Usually most prominent frontally in adults (e.g. FIRDA - Frontal Intermittent Rhythmic Delta) & posteriorly in children e.g. OIRDA - Occipital Intermittent Rhythmic Delta).

http://www.medicine.mcgill.ca/physio/vlab/biomed_signals/eeg_n.htm

Morphology

Monomorphic: composed of one dominant activity
Polymorphic: multiple frequencies combine to form a complex waveform.
Sinusoidal: Resembling sine waves.
Transient: Isolated wave distinctly different from background activity.

http://www.medicine.mcgill.ca/physio/vlab/biomed_signals/eeg_n.htm


5. EEG Examples
6. Sleep, anesthesia, and EEG
7. EEG frequencies and burst suppression
Content and Lecture by: Michael Avidan
Prezi by: Andrew Park
Full transcript