ELECTRO ENCEPHALO GRAPHY

Introduction: An electroencephalogram (EEG) is a test that detects electrical activity in

brain using small metal disc (electrodes) attached on the scalp. The brain cells communicate
via electrical impulses and are active all the time. This activity shows up as wavy lines on an
EEG recording.

Definition: An EEG is a procedure that detects abnormalities in brain waves, or in the

electrical activity of the brain. An EEG tracks and records brain wave patterns. Small metal
disc with thin wires (electrodes) are placed on the scalp, and then send signals to a computer.

Indications: An EEG is used to detect problems in the electrical activity of the brain that may
be associated with certain brain disorders. The measurement given by an EEG are used to
confirm the various conditions:

 Seizure disorders (Epilepsy)

 Head injury
 Encephalitis (inflammation of the brain)
 Brain Tumor
 Encephalopathy (disease that causes brain dysfunction)
 Memory problems
 Sleep disorders
 Stroke
 Dementia
 When someone is in coma, an EEG may be performed to determine the brain activity
 The EEG is also used in making a determination of brain death.

Purposes of EEG:

 To determine the presence of any type of seizure disorder.

 To aid in the diagnosis of intracranial lesion such as abscesses and tumor.
 To evaluate the brain’s electrical activity in metabolic disease, cerebral ischemia,
head injury, meningitis, encephalitis, mental retardation, psychological disorder.
 To evaluate altered state of consciousness of brain death.

Types of EEG:

Routine EEG test: -

It is usually done at an outpatient appointment at the hospital. The appointment normally

lasts between one and one and a half hour. Patient go home as soon as the test has been done.
During the test, the patient sits or lie down. The person who does the test will attach the
electrodes to the patient’s head with a sticky gel. They may ask to breathe deeply for some
minutes and also to look at a flashing light, these activities can change the electrical activity
in the brain and these will show on the computer. Ask the patient to keep as still as possible
during the test. Any movement can change the electrical activity in the brain, which can
affect the result.

Sleep EEG tests: -

Sleep EEG test is done while the patient is asleep. This will be done because the seizures
happen when one is asleep or tired. When one is asleep, the brain wave patterns change and
may show more unusual electrical activity. A sleep EEG test is usually done in hospital,
using a standard EEG machine. Before the test, the patient may be given some medicine to
make go to sleep. The test last for one to two hours and go home once the patient is away.

Sleep deprived EEG tests: -

Sleep deprived EEG test is done when patients have less sleep than usual. When patients is
tired, there is more chance that there will be unusual electrical activity in brain. The doctor
may ask to have this test if patients have had a standard EEG test, but it didn’t show any
unusual electrical activity. Before asleep Sleep deprived EEG test, doctor may ask to patients
not to go to sleep at all the night before, or to wake up much earlier than he usually done. The
beginning of the sleep deprived EEG test is the same as a standard EEG test. Patients then
may fall asleep or doze while the EEG is still recording the activity in brain. The test last for
a few hours and patient usually go to home once the patient is awake.

Ambulatory EEG test: -

Ambulatory means design for walking. So, individual can have an ambulatory EEG test
while he is moving around. An ambulatory EEG test is designed to record the activity in
brain over a few hours, days or weeks. This means there is more chance that it will pick up
epileptic activity in brain, than during a standard EEG test.

An ambulatory EEG uses electrodes similar to those used on a standard EEG test. However,
the electrode that are attached to patient’s head are plugged into a small machine that records
the result. Clients can wear the machine on a belt so he is able to go about his daily business.
Client do not usually stay in hospital while the test is being done.

Doctor will ask to him to keep a diary of his activities, such as sleeping and eating, while he
is. wearing the ambulatory EEG. They will also ask to the clients or somebody who is with
the patient to keep a detailed record of any of any seizures he had. They will then be able to
match up what has been happening with the results of client’s brainwave activity on the EEG
test result.

Video telemetry test: -

During a video telemetry test, patient need to stay in hospital. A video telemetry test involves
wearing an ambulatory EEG (see above). At the same time all movement are recorded by a
video camera. The test is usually carried out over a few days. Sometimes Patients epilepsy
medicine may be reduced or withdrawn. This is to increase the chances that patients will have
a seizure that can be recorded. After the test doctor can watch the video to see any seizures
that he had. They can also look at the EEG results for the time clients having the seizure. This
will tell them about any changes to patient’s brain wave pattern at the time of the seizure.
Patients usually only have a video telemetry test if he has already been diagnosed with
epilepsy. Here are some examples of why doctor might ask for a video telemetry test:

It is not clear what type of seizures client has.

Clients’ epilepsy medicine is not working well

There is a possibility that client’s seizures are not caused by epilepsy, but something else.

Component of EEG:

1. Electrodes: - Small metal discs, usually made of stainless steel, tin, gold or silver
covered with a silver chloride coating. Placed on the scale in special position. Each
electrode site is labeled with a letter and a number, the letter refers to the area of brain
underline the electrode. Even numbers, denote the right side of the head and odd
numbers denote the left side of the head.
2. Amplifier: - It is an electronic device that increases the power of a signal. It does this
by taking energy from a power supply and controlling the output to match the input
signal shape, but with a larger amplitude. Human brain wave activity is too subtle to
read unless the signal is amplified. These units available now usually connect through
a USB port and transmit signal to the therapist computer.
3. Filters: - The use of filters in recording and displaying EEG data is an indispensable
tool in producing interpretable EEG tracing. Without filters, many segments of EEG
would be essentially unreadable.
4. Writing unit: - The final link between the patient and legible EEG tracing is the
writer. A pen -ink -paper system is employed. The writing unit may be replaced by a
digital screen in modern EEG devices.
 Preparation of patient before EEG:

 Explain the patient that the EEG records the brain’s electrical activity.
 Sign a consent form by the patient that gives him/her permission to do the
procedure.
 Describe the procedure to the patient and family members and answer all the
questions.
 Wash hair with shampoo the night before the EEG or in morning day of EEG, and
do not put any products like spray or gel or conditioner on the hair on the night
before the test.
 Doctor should be asked if any stop of medications before the test.
 A medicines list should be made and sent to dept where technician performing the
EEG.
 Avoid eating or drinking anything containing caffeine for at least eight to twelve
hours before the test.
 Inform the patient smoking is prohibited for at least 8 hours before the test.

During the procedure of EEG:

An EEG measures the electrical impulses in the brain by using several electrodes that are
attached in the scalp. An electrode is a conductor through which an electric current enters or
leaves. The electrodes transfer information from your brain to a machine that measures and
records data.

The test usually takes 30-60 minutes to complete, and involves the steps include:

 The patient should be lie on a bed.

 The technician will measure the head and mark where to place the electrodes. These
spots are scrubbed with a special cream that helps the electrodes get a high-quality
reading.
 The technicians will put a sticky gel adhesive on 16 to 25 electrodes and attach them
to spots on the scalp.
 When the tests begin the electrodes send electrical impulse data from your brain to the
recording machine. this machine converts the electrical impulse into visual patterns
that appears on a screen, A computer save this pattern.
 The technician may instruct the patient to do certain things while the test is in
progress. They may ask to lie still, close the eyes, breathe deeply, or look at stimuli
(such as a flushing light or a picture).
 During the test, very little electricity passes between the electrodes and your skin.

After the test:

 After the EEG is over continue same medicines as ordered by doctor.

 Carefully observe the patient for any seizure disorder and provide a safe
environment.
  Help the patient remove electrodes paste from his hair.
 If clinical events are found to be nonepileptic, a psychological evaluation may be
needed.

Conclusion:

The EEG is used in the evaluation of brain disorders. Most commonly it is used to show the
type and location of the activity in the brain during a seizure. It is also used to evaluate
people who are having problems associated with brain functions. This problem might include
confusion, coma, tumors, long term difficulties with thinking or memory or weakening of
specific parts of the body (such as weakness associated with a stroke). In general EEG is the
best method to diagnose a disease and it is better than its alternatives for many reasons, and
there are almost no low-cost alternatives to EEG.
 OBSERVATION REPORT
OF
ELECTROENCEPHALOGRAM

SUBMITTED TO

PROFESSOR KALYANI SAHA SUBMITTED BY:

APOLLO COLLEGE OF NURSING SUMITA MUKHOPADHYAY
M.Sc. NURSING STUDENT, PART-I
APOLLO COLLEGE OF NURSING