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ENCEPHALO
GRAPHY
:- To check the records of brain
waves, and to detect the level of
electrical activity in the brain is
called EEG
The "10-20 System" of Electrode Placement
Note:-
EEG may confirm brain death in someone who is in a coma.
ATYPICAL BUT NORMAL WAVE FORMS
K Complexes occur in sleep when
arroused - thus K complexes are
seen with noises or other stimuli
especially in stage 2 sleep. The
K complex is often followed by an
arrousal response - namely a
run of theta waves of high
K Complexes amplitude. Following this the
EEG shows sleep again or the
awake state.
Lambda and POSTS are similar
morphologically, and have a
triangular shape.They occur
posteriorly and symmetrically.
POSTS stands for 'positive
occipital transients of sleep' and
occurs in stage 2 sleep.
Lambda occurs in the awake
Lambda and POSTS patient when the eyes stare at
blank surfaces. Both are normal
wave forms and can occur singly or
inlong or short runs.
V waves occur in the parasaggital
areas of the two sides and take the
form of sharp waves or even spikes
which show in the biparietal
regions(vertex) withphase reversal
at the midline in tranverse
montages or at the vertex in front-
V Waves to-back ones. They are seen
in stage 2 sleep along with spindles,
K complexes, POSTS, etc..
Mu activity is a rhythm in which the
waves have a shape
suggestive of a wicket fence with
sharp tips and rounded bases.
It may show phase reversal between
two channels. The frequency
is generally half of the fast activity
MU activity present.
Psychomotor variant is a rare
rhythm which appears to be an
harmonic of two or more basic
rhythms causing a complex
form. As can be seen it is higher
in amplitude than the surround
and the waves have a notched
appearance. It is quite
Psychomotor Variant assymetrical and is often
mistaken for paroxysmal
activity. It is benign. It is also
known as
Fourteen and six activity
is most often seen in
children and adolescents.
As seen it takes the form
of 6 Hz and 14 Hz waves
sometimes going in the
same direction(up or
down) and in others in
Fourteen and Six Rhythm opposite directions. It is
typically seen in sleep or
drowsiness and is usually
seen in monopolar
recordings.
ELECTRO
MIO
GRAPHY
Amplifier parameters Chann Sensitivity Scaling for fo fu 50 Hz notch Rctf. Ext. Auto-matic
e analysis Input offset
l
s
Spontanous 1 0,1 mV/div 0,1 mV/div 10 kHz 5 Hz x x
Aquisition- Monitor time Analysis time Trigger-mode Averager Sweeps (no. of passes) Artefact
parameters mode Detection
Spontan-aktivität 10 ms/div 10 ms/div Internal Standard --- ---
Trapezius
Sternocleidomast Tongue -
Orbicularis Oris oid Genioglossus
NEEDLE EMG | FOOT MUSCLES
First Dorsal
Interosseous -
Foot
NEEDLE EMG | FOREARM MUSCLES
Ancone
us
BRACHIORADIALIS EXTENSOR DIGITORUM
ANCONEUS
COMUNIS
Stim Points:
Elbow / Wrist
MEDIAN SENSORY / Index Stim Points:
Distance = 8cm Elbow / Wrist
ULNAR MOTOR / ADM
Distance = 5cm
Stim Points:
Above Elbow / Below Elbow / Wrist
ULNAR Stim Points:
SENSORY / Vth Elbow / Wrist
Distance = 8cm
RADIAL SENSORY / Dors Hnd Stim Points:
Distance = 10cm Forearm
Major nerves of LLs
(Lower Limbs) are:-
PERONEAL MOTOR / EDB
Distance = 7cm
Stim Points:
Above/Below-Fibular Head/Ankle
PERONEAL SENSORY Stim Points:
Distance = 14cm Dist / Prox
POSTERIOR TIBIAL MOTOR
Distance = 14cm
LOCATION
Most frequently at the Head of the Fibula
No associated pain
WHAT IS INVOLVED
Radial Nerve
LOCATION
Most frequently at the Spiral Groove of the humerus
Could be at the Axilla (Saturday Night palsy)
No associated pain
LOCATION
Posterior Tibial nerve entrapment at the Tarsal
Tunnel in the foot at the level of the medial malleolous
COMMON SYMPTOMS
Foot, Ankle, Sole pain/burning and aching
Worse at night
No muscle weakness
Usually unilateral
WHAT IS INVOLVED
Ulnar Nerve
LOCATION
WHAT IS INVOLVED
LOCATION
Dropping objects
• BAEP
• SSEP
VISUAL
EVOKED
POTANTIAL
:- To check the
electrical activity of
optic (eyes) nerve.
Amplifier Channels Sensitivity Scaling for fo fu 50 Hz notch Rctf. Ext. Auto-
parameters analysis Input matic
offset
1 20 µV/div 2 µV/div 100 Hz 0,5 Hz x x
Stimulation- Stim. Ferquency Stim. Type Stim. Field Size Patter Stim. Contrast Trace
parameters n Mode s
Aquisition- Monitor Analysis time Trigger- Averager Sweeps (no. Artefact Artefact
parameters time mode mode of passes) treshold Detection
Stimulation- Stim. Stim. Stim. Field Polarity Volume stimulus Volume noise Contrast
parameters Ferquency Type
Aquisition- Monitor Analysis time Trigger- Averager Sweeps (no. Artefact Aquisitionparame
parameters time mode mode of passes) Detection ters
SEP N. tibialis 20 ms/div 10 ms/div Internal Standard 400 --- ---
SEP N. medianus 20 ms/div 10 ms/div Internal Standard 200
Cogan
Tensilon test: Before (left); After (right)
Repetitive Nerve Stimulation
NERVE CONDUCTION QUICK
SET-UPS | BLINK / FACIAL