1. G is for generalized
Activity that affects the brain as a whole, or is present in every channel of the EEG.
Also can use the word diffuse.

2. 7 y/o male being evaluated for episodes of starring off, occurring multiple times daily

3. H is for hyperventilation
Activation procedure consisting of deep regular breaths of about bpm. This causes constriction of cerebral arteriolar system and hypoxia (low levels of oxygen in the blood).
Should be performed for 2-3 minutes
May cause normal high amplitude, generalized slowing pattern known as a “build-up response”.
Performed to illicit 3Hz generalized spike and wave discharges in patients with petit mal or absence seizures.
Contraindications include: cardiovascular problems, respiratory disorders, extreme hypertenison, subarachnoid hemorrhage, or recent stroke.

4. 6 y/o female being evaluated for behavioral problems…eeg to rule out seizures. Pt is currently on no medications

5. H is also for history
Document age, family history , pt symptoms, relevant medical history, behavior state of patient, last episode occurrence, medications, or auras.
Date and time of recording should also be annotated. As well as record ID.

6. I represents “Intermittent”
Term that means: happens sporadically. It is activity that may come and go.

7. K is for K-complex.
High amplitude delta wave activity that occur diffusely, but predominately over the vertex region. The slow, delta wave activity may be followed by a short period of 8-12 cps alpha-like activity.
Most prominate in stage II sleep.
Some sources say the are products of slight arousal.
Best seen in a transverse montage.

8. L is for localization
The act of isolating the origin of the abnormality.
In a referential montage, localize by highest amplitude.
In a bipolar montage, localize by phase reversal.

9. M is for montages..
System of grouping electrode pairs in a specific order.
A referential montage consists of groupings of one active (scalp) electrode, and one inactive (non-cephalic) electrode.
which exception of a Cz reference, where Cz is used as a reference site, but is technically active.
A bipolar montage consists of electrode groupings which are both active (scalp) electrodes.

10. N is for notch, or 60hz filter!
An active setting used to filter out fast, 60cps artifact caused by electrical interference.
When notch filter is on, it can rid 60Hz artifact ( very fast, black “fuzzy” recording), but it can attenuate frequencies as low as 10Hz.
Source of artifact should be eliminated ( if possible) before the notch filter be used.
Caused by: recording in an electrically hostile environment, a bad ground electrode, a bad scalp or reference electrode, high impedances, bad jackbox.

11. O is for OIRDA Occipital Intermittent rhythmic delta activity.
This abnormal slowing recorded from the posterior head regions. Usually after a stroke or trauma.

12. P is for parameters
The low filter will attenuate slower frequencies, but will not effect faster frequencies . The normal low filter setting is 1Hz. A higher LFF setting of 3Hz or 5Hz will attenuate greater amounts of slowing.
The high frequency filter will attenuate higher frequencies, but will not effect the slower ones. A normal HFF filter setting is 70Hz. A lesser HFF setting of 35Hz or 10Hz will attenuate a greater amount of faster activity.

13. Parameters continued…….
A normal paperspeed is 30mm/sec or 10sec/pg.
To enhance slowing, use a slower paperspeed of 15mm/sec or 20sec/pg.
In order to “spread out” faster frequencies to localize a abnormality, or to count out 60Hz contamination, increase the paperspeed to 60mm/sec, or 5sec/pg.

14. P also stands for polarity
If input 2 is more positive than input 1, pen deflection will go up.
If input 2 is more negative in relation to input 1, pen deflection will go down.

15. P is also for Photic Stimulation
Activation procedure consisting of flashes of light focused on the pt’s facial region at selected frequencies.
May produce a driving response, which is a normal variant, identified as sinusoidal waveforms produced in the posterior head regions that are half, equal to, or double the rate of the photic speed.
May also produce abnormal responses:
- Asymmetrical driving response ( driving response over only one side for posterior head region
- Photo-Paroxysmal Response ( Generalized spike/wave discharges that often outlast the the photic stimulation. No clinical signs.
- Photoconvulsive Response ( Pt sent into a T/C seizures that also outlast the photic stimulation.

16. Q is for Quiescence Another term for inactivity or quietness.
Used to describe the EEG of a neonate born at or before 22 weeks conceptual age.

17. R is for RECORD
Record must have be acquired within 12 months of the exam.
Records must contain a minimum of 16 channels.
Records should not be indicative of: ECI,
status epilepticus, surgical monitoring, ambulatory, long term epilepsy monitoring, neonatal recordings.
Record should contain at least one period of eye opening and closing.

18. S is for Sleep
In a 1947 study of 500 cases of epilepsy, epileptic activity was more that twice as likely to occur during sleep.
This is especially true in cases of temporal lobe epilepsy.
Stage I characterized by attenuation of the background, slow rolling eye movements.
Stage II defined by sleep spindles
Stage III defined as 20-50% of the record

19. Trace Alternant

20. T is for Time
Record should be a minimum of 20 minutes or 120 pages long no including calibration and bio-calibration

21. BREECH rhythm is not an acceptable abnormality.
U is for Understand
BREECH rhythm is not an acceptable abnormality.

22. V is for Vertex Sharp waves
Appear between 3-6 months of life.
Moderate to high amplitude, sharp and biphasic waves lasting msec in duration.
Usually a surface negative wave, followed by a positive component.