Type of Surgery
Last updated: 02/17/2009
Before an EEG begins, a nurse or technologist attaches approximately 16â€“21 electrodes to a person's scalp
using an electrically conductive, washable paste. The electrodes are placed on the head in a standard pattern based on head...
circumference measurements. Depending on the purpose for the EEG, implantable, or invasive, electrodes are occasionally used. Implantable electrodes include sphenoidal electrodes, which are fine wires inserted under the zygomatic arch, or cheekbone. Depth electrodes, or subdural strip electrodes, are surgically implanted into the brain and are used to localize a seizure focus in preparation for epilepsy surgery. Once in place, even implantable electrodes do not cause pain. The electrodes are used to measure the electrical activity in various regions of the brain over the course of the test period.
For the test, a person lies on a bed, padded table, or comfortable chair and is asked to relax and remain still while measurements are being taken. An EEG usually takes no more than one hour, although long-term monitoring is often used for diagnosis of seizure disorders. During the test procedure, a person may be asked to breathe slowly or quickly. Visual stimuli such as flashing lights or a patterned board may be used to stimulate certain types of brain activity. Throughout the procedure, the electroencephalography unit makes a continuous graphic record of the person's brain activity, or brain waves, on a long strip of recording paper or computer screen. This graphic record is called an electroencephalogram. If the display is computerized, the test may be called a digital EEG, or dEEG.
The sleep EEG uses the same equipment and procedures as a regular EEG. Persons undergoing a sleep EEG are encouraged to fall asleep completely rather than just relax. They are typically provided a bed and a quiet room conducive to sleep. A sleep EEG lasts up to three hours, or up to eight or nine hours if it is a night's sleep.
In an ambulatory EEG, individuals are hooked up to a portable cassette recorder. They then go about normal activities and take normal rest and sleep for a period of up to 24 hours. During this period, individuals and their family members record any symptoms or abnormal behaviors, which can later be correlated with the EEG to see if they represent seizures.
An extension of the EEG technique, called quantitative EEG (qEEG), involves manipulating the EEG signals with a computer using the fast Fourier transform algorithm. The result is then best displayed using a colored gray scale transposed onto a schematic map of the head to form a topographic image. The brain map produced in this technique is a vivid illustration of electrical activity in the brain. This technique also has the ability to compare the similarity of the signals between different electrodes, a measurement known as spectral coherence. Studies have shown the value of this measurement in diagnosis of Alzheimer's disease and mild closed head injuries. The technique can also identify areas of the brain having abnormally slow activity when the data are both mapped and compared to known normal values. The result is then known as a statistical or significance probability map (SPM). This allows differentiation between early dementia (increased slowing) or otherwise uncomplicated depression (no slowing).
Electroencephalography (EEG) is the measurement of electrical activity produced by the brain as recorded from electrodes placed on the scalp.
Just as the activity in a computer can be understood on multiple levels, from the activity of individual transistors to the function of applications, so can the electrical activity of the brain be described on relatively small to relatively large scales. At one end are action potentials in a single axon or currents within a single dendrite of a single neuron, and at the other end is the activity measured by the EEG which aggregates the electric voltage fields from millions of neurons. So-called scalp EEG is collected from tens to hundreds of electrodes positioned on different locations at the surface of the head. EEG signals (in the range of milli-volts) are amplified and digitalized for later processing. The data measured by the scalp EEG are used for clinical and research purposes. In neurology, the main diagnostic application of EEG is for epilepsy but this technique is also used to investigate many other pathologies such as sleep-related disorders, sensory deficits, brain tumors, etc. In cognitive neuroscience, EEG is used to investigate the neural correlates of mental activity from low-level perceptual and motor processes to higher-order cognition (attention, memory, reading, etc).
For a neurosurgery, as for any other surgery, it's important to always bring x-rays and any other medical records the patients has.
-Dr Catherine McAuley
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