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What is the primary purpose of the American Clinical Neurophysiology Society (ACNS) standardized critical care EEG terminology?
What is the primary purpose of the American Clinical Neurophysiology Society (ACNS) standardized critical care EEG terminology?
- To describe the morphology of each pattern
- To identify which patients are most at risk for seizures
- To standardize the description of rhythmic, periodic, and fluctuating patterns (correct)
- To determine the interrater reliability of EEG interpretations
What is the range of interrater reliability for main terms 1 and 2 and the majority of the modifiers among trained users?
What is the range of interrater reliability for main terms 1 and 2 and the majority of the modifiers among trained users?
- kappa = 0.5–0.7
- kappa = 0.2–0.4
- kappa = 0.1–0.3
- kappa = 0.8–1.0 (correct)
What is the term that describes the morphology of each pattern in the ACNS standardized critical care EEG terminology?
What is the term that describes the morphology of each pattern in the ACNS standardized critical care EEG terminology?
- Modifier
- Main term 2 (correct)
- Location term
- Main term 1
Which of the following is NOT a main term in the ACNS standardized critical care EEG terminology?
Which of the following is NOT a main term in the ACNS standardized critical care EEG terminology?
What is the significance of the ACNS standardized critical care EEG terminology in multicenter research?
What is the significance of the ACNS standardized critical care EEG terminology in multicenter research?
Which of the following is an additional modifier in the ACNS standardized critical care EEG terminology?
Which of the following is an additional modifier in the ACNS standardized critical care EEG terminology?
What is excluded from the standardized critical care EEG terminology?
What is excluded from the standardized critical care EEG terminology?
What is a characteristic of a generalized pattern in the standardized critical care EEG terminology?
What is a characteristic of a generalized pattern in the standardized critical care EEG terminology?
How many main terms are assigned to each pattern in the standardized critical care EEG terminology?
How many main terms are assigned to each pattern in the standardized critical care EEG terminology?
What is the minimum duration required for a rhythmic or periodic pattern to be included in the standardized critical care EEG terminology?
What is the minimum duration required for a rhythmic or periodic pattern to be included in the standardized critical care EEG terminology?
What type of discharges are included in the standardized critical care EEG terminology if their frequency is less than 4 Hz?
What type of discharges are included in the standardized critical care EEG terminology if their frequency is less than 4 Hz?
How many modifiers can be applied to a pattern in the standardized critical care EEG terminology?
How many modifiers can be applied to a pattern in the standardized critical care EEG terminology?
What determines the first main term of a pattern in the standardized critical care EEG terminology?
What determines the first main term of a pattern in the standardized critical care EEG terminology?
What is the definition of an 'evolving discharge' in the standardized critical care EEG terminology?
What is the definition of an 'evolving discharge' in the standardized critical care EEG terminology?
What was the primary purpose of developing the standardized EEG terminology?
What was the primary purpose of developing the standardized EEG terminology?
What is the primary tool used for assessing neurologic function in many ICUs?
What is the primary tool used for assessing neurologic function in many ICUs?
What does the term 'frontally predominant' mean in relation to EEG patterns?
What does the term 'frontally predominant' mean in relation to EEG patterns?
What is the term for patterns seen synchronously over both hemispheres but clearly more prominent on one side?
What is the term for patterns seen synchronously over both hemispheres but clearly more prominent on one side?
What is the significance of the term 'generalized periodic epileptiform discharges' (GPEDs)?
What is the significance of the term 'generalized periodic epileptiform discharges' (GPEDs)?
Which of the following patterns involves at least three discrete brain regions and both hemispheres?
Which of the following patterns involves at least three discrete brain regions and both hemispheres?
What does the modifier '+F' indicate in the context of EEG patterns?
What does the modifier '+F' indicate in the context of EEG patterns?
What is the main difference between the terms 'GPEDs' and 'GPDs'?
What is the main difference between the terms 'GPEDs' and 'GPDs'?
Which of the following patterns does not have a modifier?
Which of the following patterns does not have a modifier?
What is the term for patterns occurring independently over both hemispheres?
What is the term for patterns occurring independently over both hemispheres?
Which of the following terms describes the amplitude of EEG patterns in midline derivations compared to parasagittal derivations?
Which of the following terms describes the amplitude of EEG patterns in midline derivations compared to parasagittal derivations?
What is the term for patterns that are not otherwise specified in terms of localization?
What is the term for patterns that are not otherwise specified in terms of localization?
What is the significance of the kappa value of 0.8-1.0 in the context of interrater reliability?
What is the significance of the kappa value of 0.8-1.0 in the context of interrater reliability?
What is the significance of the ACNS standardized critical care EEG terminology in identifying patients at risk for seizures?
What is the significance of the ACNS standardized critical care EEG terminology in identifying patients at risk for seizures?
What is the primary characteristic of the main terms in the ACNS standardized critical care EEG terminology?
What is the primary characteristic of the main terms in the ACNS standardized critical care EEG terminology?
What is the significance of the bilateral independent (BI) main term in the ACNS standardized critical care EEG terminology?
What is the significance of the bilateral independent (BI) main term in the ACNS standardized critical care EEG terminology?
What is the significance of the multifocal (Mf) main term in the ACNS standardized critical care EEG terminology?
What is the significance of the multifocal (Mf) main term in the ACNS standardized critical care EEG terminology?
What is the significance of the term 'triphasic waves' in traditional EEG terminology?
What is the significance of the term 'triphasic waves' in traditional EEG terminology?
What is the primary tool used for assessing neurologic function in many ICUs?
What is the primary tool used for assessing neurologic function in many ICUs?
What is the main difference between the terms 'GPEDs' and 'GPDs'?
What is the main difference between the terms 'GPEDs' and 'GPDs'?
Why was standardized EEG terminology developed for critically ill patients?
Why was standardized EEG terminology developed for critically ill patients?
What is the minimum frequency of generalized spike-wave discharges that are excluded from the standardized critical care EEG terminology?
What is the minimum frequency of generalized spike-wave discharges that are excluded from the standardized critical care EEG terminology?
What is the characteristic of a pattern that is assigned the main term 'Generalized'?
What is the characteristic of a pattern that is assigned the main term 'Generalized'?
What is the minimum duration required for a rhythmic or periodic pattern to be included in the standardized critical care EEG terminology?
What is the minimum duration required for a rhythmic or periodic pattern to be included in the standardized critical care EEG terminology?
What is the criterion for assigning the main term 'Generalized' to a pattern?
What is the criterion for assigning the main term 'Generalized' to a pattern?
What type of discharges are included in the standardized critical care EEG terminology if their frequency is less than 4 Hz?
What type of discharges are included in the standardized critical care EEG terminology if their frequency is less than 4 Hz?
What is the main difference between the main terms 'Generalized' and 'Focal' in the standardized critical care EEG terminology?
What is the main difference between the main terms 'Generalized' and 'Focal' in the standardized critical care EEG terminology?
What is the characteristic of a pattern that is excluded from the standardized critical care EEG terminology?
What is the characteristic of a pattern that is excluded from the standardized critical care EEG terminology?
What is the purpose of assigning two main terms to each pattern in the standardized critical care EEG terminology?
What is the purpose of assigning two main terms to each pattern in the standardized critical care EEG terminology?
What is the term that describes patterns where amplitude in posterior derivations is 50% or less than anterior derivations?
What is the term that describes patterns where amplitude in posterior derivations is 50% or less than anterior derivations?
Which pattern involves at least three discrete brain regions and both hemispheres?
Which pattern involves at least three discrete brain regions and both hemispheres?
What is the term for patterns that are synchronous and seen bilaterally but clearly more prominent over one hemisphere?
What is the term for patterns that are synchronous and seen bilaterally but clearly more prominent over one hemisphere?
What is the significance of the modifier '+F' in the context of EEG patterns?
What is the significance of the modifier '+F' in the context of EEG patterns?
What is the term for patterns where amplitude in midline derivations is 50% or less than parasagittal derivations on an average or noncephalic referential recording?
What is the term for patterns where amplitude in midline derivations is 50% or less than parasagittal derivations on an average or noncephalic referential recording?
What is the term for patterns occurring independently over both hemispheres?
What is the term for patterns occurring independently over both hemispheres?
Which pattern does not have a modifier?
Which pattern does not have a modifier?
What is the term for patterns that are not otherwise specified in terms of localization?
What is the term for patterns that are not otherwise specified in terms of localization?
Study Notes
Overview of Standardized Critical Care EEG Terminology
- The American Clinical Neurophysiology Society (ACNS) developed standardized critical care EEG terminology to describe rhythmic, periodic, and fluctuating patterns in critically ill patients.
- The core nomenclature includes two main terms: Main term 1 describes the location of each pattern (generalized, lateralized, bilateral independent, or multifocal), and Main term 2 describes the morphology of each pattern (periodic discharges, rhythmic delta activity, or spike-wave).
- Additional modifiers include descriptions of frequency, amplitude, number of phases, prevalence, duration, and polarity.
Background and Rationale
- The ACNS terminology was originally developed for research purposes but is now commonly used for clinical purposes at many academic medical centers utilizing continuous EEG (cEEG).
- The rationale for developing standardized terminology was to create an objective EEG classification scheme using descriptive terms that are not biased regarding the clinical significance of a given pattern.
- The terminology excludes patterns that most electroencephalographers consider definite electrographic seizures.
Concepts and Organization
- The terminology includes any rhythmic or periodic pattern that continues for at least six cycles (e.g., 1 per second for 6 seconds, or 3 per second for 2 seconds).
- All patterns described by the terminology are assigned two main terms, with several modifiers that can be applied as appropriate.
Main Terms and Modifiers
- Main term 1: Location of a given pattern (Generalized, Lateralized, Bilateral-independent, or Multifocal).
- Main term 2: Morphology of each pattern (Periodic Discharges, Rhythmic Delta Activity, or Spike-Wave).
- Modifiers include:
- Prevalence (% of record)
- Duration
- Frequency (cycles/sec)
- Number of phases
- Sharpness (superimposed fast, rhythmic, or sharp waves or spikes)
- Polarity (not specified in the text)
Interrater Reliability and Clinical Applications
- Interrater reliability is almost perfect (kappa = 0.8–1.0) for main terms 1 and 2 and the majority of the modifiers.
- Recent studies have shown that this nomenclature can be used for multicenter research and may help identify which patients are most at risk for seizures.
Overview of Standardized Critical Care EEG Terminology
- The American Clinical Neurophysiology Society (ACNS) developed standardized critical care EEG terminology to describe rhythmic, periodic, and fluctuating patterns in critically ill patients.
- The core nomenclature includes two main terms: Main term 1 describes the location of each pattern (generalized, lateralized, bilateral independent, or multifocal), and Main term 2 describes the morphology of each pattern (periodic discharges, rhythmic delta activity, or spike-wave).
- Additional modifiers include descriptions of frequency, amplitude, number of phases, prevalence, duration, and polarity.
Background and Rationale
- The ACNS terminology was originally developed for research purposes but is now commonly used for clinical purposes at many academic medical centers utilizing continuous EEG (cEEG).
- The rationale for developing standardized terminology was to create an objective EEG classification scheme using descriptive terms that are not biased regarding the clinical significance of a given pattern.
- The terminology excludes patterns that most electroencephalographers consider definite electrographic seizures.
Concepts and Organization
- The terminology includes any rhythmic or periodic pattern that continues for at least six cycles (e.g., 1 per second for 6 seconds, or 3 per second for 2 seconds).
- All patterns described by the terminology are assigned two main terms, with several modifiers that can be applied as appropriate.
Main Terms and Modifiers
- Main term 1: Location of a given pattern (Generalized, Lateralized, Bilateral-independent, or Multifocal).
- Main term 2: Morphology of each pattern (Periodic Discharges, Rhythmic Delta Activity, or Spike-Wave).
- Modifiers include:
- Prevalence (% of record)
- Duration
- Frequency (cycles/sec)
- Number of phases
- Sharpness (superimposed fast, rhythmic, or sharp waves or spikes)
- Polarity (not specified in the text)
Interrater Reliability and Clinical Applications
- Interrater reliability is almost perfect (kappa = 0.8–1.0) for main terms 1 and 2 and the majority of the modifiers.
- Recent studies have shown that this nomenclature can be used for multicenter research and may help identify which patients are most at risk for seizures.
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This quiz covers the standardized critical care EEG terminology by the American Clinical Neurophysiology Society (ACNS). It includes concepts and organization of EEG terminology in critical care settings.
