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An electroencephalogram (EEG) is a critical tool in epilepsy diagnosis. The three common EEG durations are 25 minutes, 1 hour, and 24 hours. One-hour EEGs are superior in showing epileptiform abnormalities, while 24-hour EEGs are used to characterize seizure and nonepileptic event semiology and guide treatment of status epilepticus. The term EEG montage refers to the way EEG electrodes are ordered for interpretation. Odd numbered electrodes are on the left, with even numbered on the right. Smaller numbers are closer to the midline, while z means the electrode is on the midline. This chapter will explore the numerous normal and variant findings like posterior dominant rhythm (PDR) and wicket spikes. Epileptiform findings like sharp waves or seizure patterns are indicative of epilepsy. Slowing or increased amplitude can indicate cerebral changes that are not epileptiform. Electroencephalogram reports should concisely accurately convey both the electrical findings and their clinical relevance to patient care. Electroencephalogram reports should indicate an epilepsy diagnosis only when clear electrical evidence exists.
Epilepsy is a frequently encountered disease, affecting 1-2% of the population, but one that is often mistreated due to misunderstandings of specific diagnoses and treatments. This practical manual provides a succinct and clinically relevant reference of routine clinical epilepsy care. The book is designed around the four main aspects of an epilepsy patient's care: first seizure, inpatient epilepsy care, outpatient epilepsy care, and diagnostic modalities. These four aspects are carefully delineated to illustrate the key differences in best practice management. Rational use of EEG and imaging testing is thoroughly covered to guide improved utility of these results. Caring for the mental health of epilepsy patients is also covered, as this is pertinent at every stage and location of epilepsy patient care. An excellent resource for neurology trainees at the resident, fellow, and medical student level as well as advanced practice providers.
The effectiveness of electrical water bath stunning of broilers (n = 96) for 1 s with a constant average current of 100, 150 or 200 mA delivered using a variable voltage/constant current stunner with 200, 800 or 1400 Hz pulsed direct current (DC), with a mark:space ratio of 1:1, followed by slaughter using a unilateral or ventral neck cutting procedure, was evaluated. The results of a binary logistic model showed that both the electrical frequency and average current had significant effects on the probability of inducing epileptiform electroencephalogram (EEG) and therefore, of effective stunning. The results of univariate analysis showed that only slaughter method had highly significant effects on the power contents in the 13–30 Hz and 2–30 Hz EEG frequency bands. Based on these results, it is recommended that a minimum of 200 mA average (400 mA peak) current per bird should be delivered using 200 Hz pulsed DC, with a mark:space ratio of 1:1, to achieve effective water bath stunning in 80% of broilers. Frequencies of above 200 Hz pulsed DC would presumably require average currents of greater than 200 mA. Electrical water bath stunning of broilers with 200 mA average current of 200 Hz resulted in cardiac arrest in six out of eight broilers that showed epileptiform activity. Two other broilers that had cardiac arrest showed no epileptiform EEGs indicative of effective stunning. Owing to the prevalence of cardiac arrest in conscious broilers, the use of pulsed DC for water bath stunning of broilers could be questioned on ethical and bird welfare grounds.
The return to consciousness of 24 electrically stunned lambs was assessed by measurement of physiological reflexes and electroencephalography (EEG) recordings. The physical activity of the lambs after head-only electrical stunning included one tonic phase and two clonic phases. The tonic phase began immediately after the stun and ended 10 s after the stun; the first clonic phase started immediately after the tonic phase and ended 36 s after the stun, and the second clonic phase started immediately after the first clonic phase and ended 70 s after the stun. During the tonic phase and the first clonic phase, electrical activity recordings of the brain showed a dramatic increase in the relative power spectra of alpha and beta frequencies. Both frequencies returned to pre-stun levels with the end of the first clonic phase. During the second clonic phase, the relative power spectrum of theta frequency was higher than that before stunning. These results suggest that during the tonic phase and the first clonic phase, the animal was unconscious, whereas during the second clonic phase the return of some conscious function began. Spontaneous breathing returned at about 29 s post-stun, whereas the corneal reflex returned at about 38 s. It is therefore suggested that the return of spontaneous breathing is the safest indicator that the animal is close to recovering consciousness.
The effect of the pulse width of a direct current (DC) on the effectiveness of electrical water bath stunning, and slaughter, was evaluated in broilers (n = 29). Broilers were individually stunned in a water bath for 1 s with a constant peak current of 400 mA of 200 Hz DC delivered using a variable voltage/constant current stunner. The pulse width of the 200 Hz DC was set at 0.5, 1.5 or 2.5 ms (10, 30 or 50% of 5 ms current cycle). The results showed that pulse width had a significant effect on the incidence of epileptiform activity in the electroencephalograms (EEGs). A pulse width of 10% of the current cycle was less effective than pulse widths of 30 and 50% of the current cycle; there was no significant difference between a pulse width of 30 and 50%. The results of a univariate analysis showed that ventral neck-cutting resulted in a significantly shorter time to the onset of less than 10% of the pre-stun power contents in the 13–30 Hz and 2–30 Hz EEG frequency bands when compared with unilateral neck-cutting. It is concluded that a pulse width of 30 or 50% of the current cycle of 200 Hz DC, delivering 400 mA peak current, was better than using a pulse width of 10% of the current cycle.
The effectiveness of electrical water bath stunning of 172 individual broilers for 1 s with a constant root mean square (RMS) current of 100, 150 or 200 mA, delivered using a variable voltage/constant current stunner with 200, 400, 600, 800, 1000, 1200 or 1400 Hz sine wave alternating current (AC), followed by slaughter using a unilateral or ventral neck-cutting procedure, was evaluated. A binary logistic regression of broilers showing epileptiform activity or not following stunning showed that both the electrical frequency (Hz) and RMS current (mA) had a significant effect on the probability of the electroencephalogram (EEG) manifestation. The univariate analysis of variance showed that the time to the onset of less than 10% of the pre-stun relative power contents was significantly affected only by the interaction between electrical frequency and slaughter method. A similar analysis of variance of the time to reach less than 10% of the pre-stun total power content showed slaughter method, RMS current, the slaughter method/frequency interaction and the RMS current/frequency interaction to be either significant or approaching significance. Based on these results it is recommended that effective water bath stunning of broilers with a minimum constant current of 100, 150 and 200 mA could be achieved with electrical frequencies of up to 200, 600 and 800 Hz, respectively. In addition, It is likely that electrical frequencies of above 800 Hz would have required a minimum current of greater than 200 mA to induce epileptiform activity in the EEGs of broilers.
Electroencephalogram-based evidence was accepted in a UK law court for the first time in 1939. This paper gives an account of that case, not previously clinically reported, and the individuals involved. Why it was not published in the literature at the time is explored and parallels with more recent technologies are highlighted.
Head-to-body stunning is regarded as ‘best practice’ stunning for sheep. The benefits are loss of consciousness followed by cardiac arrest, death, prevention of animal movements post stun/kill and improved meat quality. Commercial equipment places electrodes on the head and back, which is known to cause pelt burning, thus reducing the value of the skins. The aim was to demonstrate that passing current at 1.5 A and 50 Hz from the top of the head to the chest in lambs for 3.1 s would result in epilepsy. Electroencephalographic (EEG) and electrocardiographic (ECG) activity was recorded in sheep using non-invasive electrodes. Measurements in this trial were successfully performed on three lambs (live weight 25 to 39 kg) which were anaesthetised and given neuromuscular blockers to inhibit muscle activity. EEG information showed that the head-to-chest stunning produced an epileptic-like episode, which was followed by an isoelectric output. ECG recordings showed that ventricular fibrillation (VF) was induced and coincided with the epileptic brain activity observed. No animals regained brain activity or sinus heart rhythm after applying the stated stunning conditions. As a conclusion, it is postulated that modified stunning equipment passing an electrical current from the top of the head to the sternum in lambs (1.5 A, 50 Hz; 3.1 s) may induce an epileptic seizure and VF.
Small laboratory animals are commonly euthanased via intraperitoneal (IP) injection of sodium pentobarbital. However, there is concern that animals may experience pain prior to loss of consciousness with this delivery route. The present study investigated electroencephalographic (EEG) nociceptive responses of anaesthetised pigs to IP sodium pentobarbital injection using an established minimal anaesthesia model. Thirty commercial white line entire male pigs aged 10-15 days were minimally anaesthetised with halothane in oxygen. Following 10 min of baseline EEG data collection, pigs had their tails docked using side-cutters and, after a further 5-min interval, were euthanased via IP injection of sodium pentobarbital (250 mg kg-1). The summary variables median frequency (F50), 95% spectral edge frequency (F95) and total power (PTOT) were derived from the EEG data. For each variable in each pig, means were calculated for the following 60-s periods: immediately prior to tail-docking (baseline 1); immediately prior to pentobarbital injection (at least 4 min after docking; baseline 2); and for two consecutive 60-s periods immediately following pentobarbital injection (P1 and P2). Statistical analyses revealed no differences between the two baseline periods, indicating that transient EEG changes induced by tail-docking had resolved prior to pentobarbital injection. IP pentobarbital injection induced a significant increase in F50 and decrease in PTOT of the EEG during P1. This response is characteristic of acute nociception, indicating that conscious pigs likely perceive IP sodium pentobarbital as painful in the period prior to loss of consciousness.
Recent developments related to quantitative analysis of the electroencephalogram (EEG) have allowed the experience of pain to be assessed more directly than has hitherto been possible. Variables derived from the EEG of animals anaesthetised using our minimal anaesthesia model respond to noxious stimulation in a manner similar to those from conscious animals. This methodology has been used in a variety of applications including the evaluation of analgesic options for painful husbandry procedures and investigation of developmental aspects of the perception of pain. We have now applied the minimal anaesthesia model to the question of the slaughter of calves by ventral-neck incision. A series of studies evaluated the magnitude of EEG response to the noxious stimulus of ventral-neck incision and the physiological mechanisms that underlie this response. We also investigated the EEG effects of stunning by non-penetrating captive bolt and the ability of such stunning to ameliorate the response to ventral-neck incision. The results demonstrate clearly, for the first time, that the act of slaughter by ventral-neck incision is associated with noxious stimulation that would be expected to be painful in the period between the incision and subsequent loss of consciousness. These data provide further support for the value of stunning in preventing pain and distress in animals subjected to this procedure. We discuss the development of the minimal anaesthesia model and its adaptation for use in the investigation of slaughter by ventral-neck incision as well as considering the contributions of these studies to the ongoing development of international policy concerning the slaughter of animals.
This study examined electroencephalographic (EEG) indices of acute nociception in pigs (Sus scrofa) aged 1, 5, 7, 10, 12 and 15 days, post-natal. Ten pigs per age were anaesthetised with halothane in oxygen and maintained at a light plane of anaesthesia. EEG was recorded bilaterally using a five-electrode montage. Following a 10-min baseline period, tails were docked using side-cutter pliers and recording continued for a further 5 min. Changes in the median frequency (F50), 95% spectral edge frequency (F95) and total power (PTOT) of the EEG were used to assess nociception. Tail-docking at one day of age induced no significant changes in the EEG spectrum. A typical nociceptive response, characterised by an increase in F50 and decrease in PTOT was evident at ten days of age, with five and seven day old pigs exhibiting responses in either F50 or PTOT only. Pooling of data into ≤ 7 days of age and > 7 days of age revealed F50 was higher overall in the older group. Whilst PTOT decreased after docking in both groups, this response was larger and more prolonged in the older group. F95 increased after docking in the older pigs only. Overall, these data provide evidence of an increase in cortical responsiveness to noxious stimulation with increasing post-natal age, suggesting there may be qualitative differences in pain perception between age groups. Further, the data provide some support for current recommendations that tail-docking and other painful husbandry procedures be performed within seven days of birth in order to minimise their impact on animal welfare.
The aim of this study was to assess brain activity in lambs during slaughter without stunning and its correlation with heart rate (HR) and the absence of physiological reflexes. The index of consciousness (IoC-view®) assesses consciousness by an algorithm that analyses the EEG and gives an index from 0 (unconscious) to 100 (conscious). Eight lambs (Merino breed) of 20 to 25 kg live weight were individually restrained in a stretcher and three skin electrodes were placed at the level of the frontal bone. The electrodes were connected to the IoC-view®. Two additional electrodes were placed on the chest and the HR was transferred to a watch monitor. Recording time started 2 min prior to sticking to attain the basal IoC and HR value of each animal. During bleeding, presence of corneal reflex and rhythmic breathing were recorded every 10 s until brain death. Rhythmic breathing disappeared at an average time of 44 (± 4.2) s after sticking, ranging between 30 and 60 s. The corneal reflex disappeared at 116 (± 11.01) s, ranging between 80 and 160 s after sticking. Changes in the brain activity occurred between 22 to 82 s after sticking (52 [± 20.2] s). In five out of six animals the HR increased (177 [± 22.7] beats min−1) compared to basal values (139 [± 8.4] beats min−1) at 115 (± 97.5) s after sticking. Both brain activity and physiological reflexes revealed that when bleeding is performed, through a transverse incision across the neck without stunning, the onset of unconsciousness could last 1 min which impaired animal welfare. This prolonged consciousness compared to other authors’ findings may be attributable to inefficient bleeding when lambs are slaughtered without head restraint.
Cognitive control impairments are observed across several psychiatric conditions, highlighting their role as a transdiagnostic marker. Individuals with attention deficit hyperactivity disorder (ADHD) have difficulties with inhibition, working memory, processing speed, and attention regulation. These cognitive control impairments may either mediate or moderate the association between neurobiological vulnerabilities and phenotypic presentation in neurodevelopmental disorders. Alternately, neurocognitive vulnerabilities in ADHD may be additive, akin to a multiple deficit model. We tested the mediation, moderation, and additive models using neurocognitive data in youth with ADHD.
7–11 year-old children diagnosed with ADHD (n = 75) and control children (n = 29) completed EEG recordings and neuropsychological testing (full scale IQ; cognitive control). Caregivers provided ADHD symptom ratings. Correlations and linear regression analyses were completed to examine the associations among cortical functioning (aperiodic slope), cognitive control, and ADHD symptoms.
We found support for an additive model wherein vulnerabilities in aperiodic slope, event-related potentials, and cognitive control each explained unique variance in ADHD symptoms. There was some evidence that cognitive control moderates the effect of atypical cortical development on ADHD symptoms. There was no support for the mediation model.
The etiology of ADHD symptoms is multifaceted and involves multiple “hits” across neurological and cognitive-behavioral factors.
The study of the brains’ oscillatory activity has been a standard technique to gain insights into human neurocognition for a relatively long time. However, as a complementary analysis to ERPs, only very recently has it been utilized to study bilingualism and its neural underpinnings. Here, we provide a theoretical and methodological starter for scientists in the (psycho)linguistics and neurocognition of bilingualism field(s) to understand the bases and applications of this analytical tool. Towards this goal, we provide a description of the characteristics of the human neural (and its oscillatory) signal, followed by an in-depth description of various types of EEG oscillatory analyses, supplemented by figures and relevant examples. We then utilize the scant, yet emergent, literature on neural oscillations and bilingualism to highlight the potential of how analyzing neural oscillations can advance our understanding of the (psycho)linguistic and neurocognitive understanding of bilingualism.
An electroencephalogram (EEG) reflects the summation of electrical activity arising from excitatory and inhibitory post-synaptic potentials of pyramidal neurons. EEG electrodes are traditionally placed on the scalp according to the International 10–20 system of electrode placement to reproducibly record cortical electrical activity. There are a number of different montages that may be used to best analyze an EEG, and allow for interpretation of the spatial distribution and localization of the EEG activity across the cortex. Neonates may require a reduced montage. Raw EEG data remain the gold standard of neurophysiological monitoring; however, reduced-montage and quantitative EEG techniques have allowed providers, particularly in the neonatal and pediatric intensive care units, to have supplementary data to interpret, in real time, at the patient’s bedside or via remote access. This chapter reviews the technical aspects of neurophysiological monitoring, including the practice and underlying principles of initiating, recording, displaying, and interpreting EEG. Quantitative trends, including CDSA and aEEG, are included.