EEG

(ElectroEncephaloGraph)
Electroencephalograph is an instrument for recording the
electrical activity of the brain, by suitably placing surface
electrodes on the scalp.
EEG describing the general function of the brain activity, is
the superimposed wave of neuron potentials operating in a
non-synchronized manner in the physical sense.
 Uses
Monitoring EEG is an effective method of diagnosing many
neurological illnesses and diseases like epilepsy, tumor,
cerebrovascular lesions, ischemia and problems associated
with trauma.
Also used in the operating room to facilitate anaesthetics
and to establish the integrity of the anaesthetized patient’s
nervous system.
Several types of electrodes may be used to record EEG like Peel and
Stick electrodes, Silver plated cup electrodes and Needle electrodes.
EEG may be recorded by picking up the voltage difference between
an active electrode on the scalp with respect to the reference
electrode in ear lobe or any part of body. This method is known as
Monopolar recording.

In Bipolar recording the voltage difference between two scalp

electrode is recorded.
Which is done with multi-channel electroencephalographs.
Montage- A pattern of electrodes on the head and the channels
they are connected to its is called a montage.
The reference electrode is generally placed on a non-active site such
as forehead or earlobe.
EEG electrodes are arranged on the scalp according to a standard
known as the 10/20 system.
There are 21 electrode locations in the 10/20 system.
This system involves the placement of electrodes at distances of 10%
and 20% of measured coronal, sagittal and circumferential arcs
between landmarks on cranium.
Electrodes are identified according to their position on the
head,
 Fp for frontal polar
 F for frontal
 C for central
 P for parietal
 T for temporal
 O for occipital
 Z denotes midline electrodes
EEG Electrodes
Electrode Montage selector-it is a large panel containing switches
that allow user to select which electrode pair will have signals
subtracted from each other to create an array of channels of output
called montage.
Preamplifier-every channel has an individual, multistage, ac coupled,
very sensitive amplifier with differential input and adjustable gain.
Sensitivity Control
Filters-
Channels-An EEG is recorded simultaneously from an array of many
electrodes.
Commercial EEG machines have up to 32 channels, although 8 or 16
channels are more common.
 Types of EEG
1. Routine EEG – Around 20 electrodes are stuck on the
scalp and EEG is recorded.
2. Sleep EEG – The EEG is recorded along with heart rate,
respiration, oxygen saturation and limb movement.
3. Ambulatory EEG – It involves the recording of EEG
throughout the day and night. Portable EEG recorder is
used.
 Alpha Wave
Characteristics:
- frequency: 8-13 Hz
-amplitude: 20-60 µV
Easily produced when quietly sitting in relaxed position with eyes
closed (few people have trouble producing alpha waves)
Occur in occipital region
Alpha blockade occurs with mental activity
 Beta Waves
Characteristics:
-frequency: 14-30 Hz
-amplitude: 2-20 µV
The most common form of brain waves. Are present during mental
thought and activity
Recorded from parietal and frontal regions
 Theta Waves
Characteristics:
-frequency: 4-7Hz
-amplitude: 20-100µV
Believed to be more common in children than adults
Temporal regions
Walter Study (1952) found these waves to be related to displeasure,
pleasure, and drowsiness
Brain disorders
 Delta Waves
Characteristics:
-frequency: .5-3.5 Hz
-amplitude: 20-200µV
Found during periods of deep sleep in most people
Cortex regions
Characterized by very irregular and slow wave patterns
Also useful in detecting tumors and abnormal brain behaviors
 Gamma Waves
Characteristics:
-frequency: 36-44Hz
-amplitude: 3-5µV
Occur with sudden sensory stimuli
EMG (Electromyograph)
Electromyograph is an instrument used for recording the
electrical activity of the muscles to determine whether the
muscle is contracting or not; or for displaying on the CRO
and loud speaker the action potentials spontaneously
present in a muscle or those induced by voluntary
contractions as a means of detecting the nature and location
of motor unit lesions; or for recording the electrical activity
evoked in muscle by the stimulation of its nerve.
• Muscle contraction due to a change in the relative sliding of thread-
like molecules or filaments
• Actin and Myosin
• Filament sliding is triggered by electrical phenomenon (ACTION
POTENTIAL, AP)
• The recording of muscle APs is called electromyography (EMG)
• The record is known as an electromyogram
Action Potential
Electromyography- is a clinical technique that involves recording of
the electrical activity generated in a muscle for diagnostic purpose.
Electromyogram- is a graphical representation of those electrical
currents associated with muscle action.
 Working
An electromyograph detects the electrical potential generated by
muscle cells when these cells are electrically or neurologically
activated.
There are 2 methods of EMG measurement in widespread use
I. Surface EMG- surface electromyography
Applied on the surface of the skin
Surface electrodes are used (Ag/AgCl coated electrodes).
Measures signals from large muscles that lie close to skin.
II. Intramuscular EMG- To perform this kind of EMG a needle
electrode or a needle containing two fine wire electrodes is
inserted through the skin into the muscle tissue.
Needle electrode – Fine needles with electrodes inserted into
the muscle.
The bare tip of the needle serves as the recording electrode.
Fine-Wire electrode – Two strands of 100m wires inserted
into the muscle belly
Used for monitoring activity from deep, small or narrow
muscle.
EMG Electrodes Fine wire

Needle electrode

Surface Electrodes
EMG is generally recorded using surface electrodes, which may be
disposable, adhesive or reusable types.
The electrodes pick up the potentials produced by contracting muscle
fibres.
The signal can be amplified and displayed on the screen of a cathode
ray tube or it is also applied to an audio amplifier connected to a loud
speaker.
A typical EMG ranges from 0.1 to 0.5mV and may contain frequency
components up to 10kHz.
 Types of EMG
1) SURFACE ELECTROMYOGRAPHY (SEMG)
• Non-invasive technique for measuring muscle electrical activity resulting from
contraction and relaxation exercises.
2) FINE WIRE ELECTROMYOGRAPHY (INTRAMUSCULAR EMG)-
• Invasive technique for measuring muscle electrical activity resulting from
contraction and relaxation exercises.
3) NEUROMUSCULAR ELECTRICAL STIMULATION (NMES)
• Burst of electrical pulses stimulate muscle contractions in targeted muscles via
electrodes.
4) EMG-TRIGGERED STIMULATION (ETS)
• ETS is a combination of two complementary EMG modalities: SEMG and NMES.
 Uses
EMG allows us to look at the electrical activity responsible for
muscle contractions and allows us to measure muscular
performance.
EMG has well established value as an evaluation tool used in applied
research, physiotherapy, rehabilitation, sports medicine and training,
biofeedback, and ergonomics research.
Practical medical applications involves EMG use in pre/post surgical
assessment and treatment, prevention or retardation of muscle
atrophy, increasing local blood circulation, relaxation of muscle
spasms, maintaining or increasing range of motion, and muscle re-
education and rehabilitation through biofeedback.
NCV (Nerve Conduction
Velocity test)
A Nerve Conduction Velocity (NCV) test , also called a Nerve
Conduction Study (NCS)--is a measurement of the speed of conduction
of an electrical impulse through a nerve. NCS can determine nerve
damage and destruction.
During the test, the nerve is stimulated, usually with surface electrode
patches attached to the skin. Two electrodes are placed on the skin
over the nerve.
One electrode stimulates the nerve with a very mild electrical impulse
and the other electrode records it. The resulting electrical activity is
recorded by another electrode.
This is repeated for each nerve being tested.
The nerve conduction velocity (speed) is then calculated by measuring
the distance between electrodes and the time it takes for electrical
impulses to travel between electrodes.
 Need of NCV
I. In general, the range of normal conduction velocity in nerve will be
approximately 50 to 60 meters per second. However, the normal
conduction velocity may vary from one individual to another and from
one nerve to another.
II. Abnormal results may be caused by some sort of neuropathy (damage
to the nerve) that can result from a contusion or traumatic injury to a
nerve. Various diseases can also cause the impulses to slow down.
III. Nerve conduction velocity is often used along with an EMG to
differentiate a nerve disorder from a muscle disorder. NCS detects a
problem with the nerve whereas an EMG detects whether the muscle
is functioning properly in response to the nerve's stimulus.
IV. Both procedures help to detect the presence, location, and extent of
diseases that damage the nerves and muscles. 
Sciatic nerve problems
Pinched nerves
Peripheral nerve injury
Nerve conduction studies may also be performed to identify the
cause of symptoms such as numbness, tingling, and continuous
pain.
• Guillain-Barré syndrome. A condition in which the body's immune system
attacks part of the peripheral nervous system. The first symptoms may
include weakness or tingling sensations in the legs.
• Carpal tunnel syndrome. A condition in which the median nerve, which runs
from the forearm into the hand, becomes pressed or squeezed at the wrist by
enlarged tendons or ligaments. This results in pain and numbness in the
fingers.
• Charcot-Marie-Tooth disease. A hereditary neurological condition that affects
both the motor and sensory nerves. One characteristic is weakness of the
foot and lower leg muscles.
• Herniated disk disease
• Chronic inflammatory polyneuropathy and neuropathy. These are conditions
resulting from diabetes or alcoholism.
 Procedure
A neurologist will locate the nerve(s) to be studied.
A recording electrode will be attached to the skin over the nerve with
a special paste and a stimulating electrode will be placed at a known
distance away from the recording electrode.
The nerve will be stimulated by a mild and brief electrical shock given
through the stimulating electrode.
Patient may experience minor discomfort for a few seconds.
The stimulation of the nerve and the detected response will be
displayed on an oscilloscope (a monitor that displays electrical activity
in the form of waves).