EEG Volume Conductors and Spatial Resolution

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Questions and Answers

What is a primary factor contributing to poor spatial resolution in scalp-recorded EEG?

  • Interference from electronic devices
  • Distortion caused by volume conductors (correct)
  • Insufficient electrode placement
  • Inadequate amplification settings

Which imaging technique can enhance the accuracy of EEG data localization?

  • Positron Emission Tomography
  • Computed Tomography
  • Functional MRI
  • Magnetoencephalography (correct)

Which of the following findings is NOT indicative of focal EEG patterns?

  • Focal epileptiform activity with slow waves
  • Focal theta–delta waves with a decrease in background activity (correct)
  • Focal amplitude depression without increased theta–delta waves
  • Focal enhancement of background activity

What type of EEG pattern is characterized by focal theta–delta slow waves with preserved background activity?

<p>Focal theta–delta waves (B)</p> Signup and view all the answers

What happens to electrical activity as it travels from the cortex to the scalp?

<p>It is attenuated and distorted (B)</p> Signup and view all the answers

Which of the following EEG findings indicates the presence of focal/unilateral epileptiform activity?

<p>Focal epileptiform activity with or without associated slow waves (B)</p> Signup and view all the answers

Which condition reflects an increase in theta–delta slow waves along with depression of basic background activity?

<p>Focal/Unilateral amplitude depression with theta–delta increase (B)</p> Signup and view all the answers

In the context of EEG findings, what is a key characteristic of focal/unilateral amplitude depression?

<p>Accompanied by an increase in theta–delta waves (C)</p> Signup and view all the answers

What is the term used for the focal amplitude accentuation resulting from a skull defect?

<p>Breach rhythm (A)</p> Signup and view all the answers

Which lobe was NOT noted to have atrophy based on the MRI findings?

<p>Right temporal lobe (A)</p> Signup and view all the answers

What type of activity showed consistent depression over the left hemisphere in the EEG?

<p>Sleep spindles (D)</p> Signup and view all the answers

What might a 'spiky'-appearing beta rhythm indicate if it is larger or more widespread than typical breach rhythm?

<p>True spike discharges (D)</p> Signup and view all the answers

Following a craniotomy, which EEG activity is most likely to enhance near the site of the skull defect?

<p>Breach rhythm (A)</p> Signup and view all the answers

What EEG finding was observed in a patient with acute aphasia and right-sided weakness due to a left middle cerebral artery infarct?

<p>Decreased background activity with continuous polymorphic delta activity in the left hemisphere (D)</p> Signup and view all the answers

What condition was mentioned in relation to the patient who had a history of closed head injury?

<p>Epidural hematoma (A)</p> Signup and view all the answers

Which type of EEG wave activity is characterized by a significant enhancement often noted as 'spiky'?

<p>Beta rhythm (B)</p> Signup and view all the answers

Which statement accurately describes the EEG characteristics related to the right subdural hematoma case?

<p>Increased amplitude of background activity and polymorphic delta slow waves over the right hemisphere (B)</p> Signup and view all the answers

The EEG changes noted in the patient primarily affected which hemisphere?

<p>Left hemisphere (D)</p> Signup and view all the answers

What was the primary EEG observation in the patient with a history of partial complex seizures due to an arachnoid cystic lesion in the right frontal lobe?

<p>Polymorphic delta from the right anterior temporal region with preserved symmetric background alpha rhythm (A)</p> Signup and view all the answers

In the case of the 62-year-old woman who experienced a left middle cerebral artery infarct, what was significant about the EEG findings?

<p>Delta activity was continuous and polymorphic in the left hemisphere (B)</p> Signup and view all the answers

Which of the following best describes the alpha rhythm findings in the patient with right-sided weakness from the left middle cerebral artery infarct?

<p>Intermittent slowing observed in the right hemisphere (D)</p> Signup and view all the answers

What distinguishes the EEG findings of the 27-year-old woman with partial complex seizures from those in other cases?

<p>Polymorphic delta activity but with preserved symmetric alpha rhythm (A)</p> Signup and view all the answers

What condition was associated with the EEG showing increased amplitude of background activity in the case of the 49-year-old man?

<p>Right subdural hematoma post craniotomy (A)</p> Signup and view all the answers

Which EEG phenomenon was absent in the right hemisphere of the patient with a left middle cerebral artery infarct?

<p>Delta-theta slow waves (D)</p> Signup and view all the answers

What is the relationship between IRDA and infratentorial lesions?

<p>IRDA can occur bilaterally or show shifting asymmetries in infratentorial lesions. (A)</p> Signup and view all the answers

How does IRDA differ from ADA in terms of responsiveness?

<p>IRDA is augmented by eye closure and hyperventilation, while ADA reacts oppositely. (C)</p> Signup and view all the answers

In which situations is focal or lateralized IRDA most likely to indicate potential seizure activity?

<p>In situations with cortical scars following insults. (B)</p> Signup and view all the answers

Which type of tumor is more likely to show epileptiform activity?

<p>Low-grade astrocytoma, due to slower progression. (D)</p> Signup and view all the answers

What is the likelihood of focal spike activity occurring immediately after a cerebrovascular accident (CVA)?

<p>Rare, as it usually appears months or years later. (D)</p> Signup and view all the answers

What type of lesions are associated with a higher occurrence of spike-wave discharges?

<p>Static or slowly progressive lesions. (D)</p> Signup and view all the answers

What amplitude characteristic is associated with IRDA in supratentorial lesions?

<p>Greater amplitude on the same side as the lesion. (D)</p> Signup and view all the answers

Which of the following statements about focal spikes is true?

<p>They may indicate a history of a focal structural lesion. (B)</p> Signup and view all the answers

What is commonly associated with the appearance of PLEDs in patients with CVA?

<p>Massive hemorrhage or infarction (B)</p> Signup and view all the answers

In which condition are PLEDs most commonly seen?

<p>Herpes simplex encephalitis (B)</p> Signup and view all the answers

What feature characterizes the EEG discharges seen in PLEDs/LPDs?

<p>They can be totally independent or time locked. (B)</p> Signup and view all the answers

What is the typical duration before PLEDs disappear after an acute infarction?

<p>Approximately 1 to 2 weeks (D)</p> Signup and view all the answers

Which of the following terms is most closely related to the evolution of PLEDs in herpes encephalitis?

<p>BiPLEDs or BIPD (D)</p> Signup and view all the answers

What is the general capability of EEG in determining the exact localization of a lesion?

<p>Fairly accurate in left/right and anterior/posterior localization (A)</p> Signup and view all the answers

Which of the following conditions would NOT likely result in the appearance of PLEDs?

<p>Chronic epilepsy (B)</p> Signup and view all the answers

What factors contribute to the development of PLEDs in patients with impaired consciousness due to acute hemispheric lesions?

<p>Massive hemorrhage or infarction (A)</p> Signup and view all the answers

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Study Notes

EEG and Spatial Resolution Issues

  • Poor spatial resolution in scalp-recorded EEG is influenced by volume conductors: cerebrospinal fluid (CSF), dura mater, skull, and scalp.
  • Electrical signals are attenuated and distorted by the time they reach the scalp, impacting the accuracy of EEG readings.
  • Combining EEG data with MRI enhances anatomical localization accuracy.

Techniques for Enhanced EEG Analysis

  • Magnetoencephalography (MEG) provides a more precise anatomical assessment of electrical sources in the brain compared to EEG.
  • Focal EEG findings can indicate various neurological conditions, with key presentations including:
    • Amplitude depression or slowing of background activity (alpha, beta waves) without increased theta-delta slow waves.
    • Amplitude depression or slowing associated with an increase in theta-delta slow waves.
    • Focal theta-delta slow waves with preserved basic background activity.
    • Focal enhancement of background activity, potentially alongside slow waves.
    • Focal or unilateral epileptiform activity, with or without associated slow waves.

Clinical Examples of Focal EEG Findings

  • EEG in a 6-year-old with focal seizures showed alpha rhythm depression over the right hemisphere without significant focal delta-theta slow waves.
  • A 62-year-old woman with acute aphasia exhibited decreased background activity and continuous polymorphic delta activity in the left hemisphere.
  • In a 27-year-old woman, EEG revealed polymorphic delta from the right temporal region while maintaining symmetric background alpha rhythm.
  • A patient with a right subdural hematoma presented increased amplitude of background activity and polymorphic delta slow waves in the right hemisphere.

Breach Rhythm and EEG Artefacts

  • Skull defects from surgeries can cause local enhancement of EEG activity (termed "breach rhythm"), particularly affecting beta rhythm.
  • “Spiky”-appearing activity in EEG may be misidentified; true spikes differ from breach rhythm spikes by exhibiting wider spread.

Intermittent Rhythmic Delta Activity (IRDA)

  • Typically appears in metabolic and toxic encephalopathy; can also present in infratentorial lesions and may exhibit bilateral symmetry.
  • Asymmetrical IRDA might indicate focal structural lesions, with characteristics such as augmentation during eye closure or hyperventilation.

Focal Epileptiform Activity

  • Cortical scarring from injuries or lesions frequently leads to epileptiform activity.
  • Spike or spike-wave discharges are most common in slowly progressive lesions, like low-grade cerebral tumors (astrocytoma).
  • Focal spikes are less prevalent immediately after cerebrovascular accidents (CVAs), often emerging months later.

Periodic Lateralized Epileptiform Discharges (PLEDs)

  • Seen in cases of significant hemispheric lesions, including massive hemorrhages or infarctions, particularly in patients with altered consciousness.
  • PLEDs may evolve in conditions like herpes encephalitis, potentially transforming into bilateral independent periodic discharges (BiPLEDs).

Localization Challenges in EEG

  • EEG is limited in accurately determining the specific location of a brain lesion; localization is generally confined to left/right and anterior/posterior quadrants.

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