Routine eeG usually begins with the patient awake with the eyes closed.

the technician asks the patient to open and close the eyes ,to assess the
posterior background rhythm and its reactivity. If activation methods are
used, they are performed during the initial segment of the EEG. Finally, the
patient is allowed to rest, progress into drowsiness and possibly fall asleep.
Evaluation of encephalopathy does not typically require a sleeping study, but
evaluation for seizures is best if a sleep sttidy is performed.
Waking
Adults with the eyes closed have a posterior dominant rhythm of about l0
Hz. The minimum allowable frequency is 8.5 Hz, and 11 Hz is the upper end
of the range. Anterior cerebral EEG shows low-voltage fast activity. Eye
movement artifact is superimposed. A frontal-predominant beta activity is
seen when patients are sedated with benzodiazepines or barbiturates, but
this is less prominent with chloral hydrate.

Digital EEG analysis shows a small amount of theta and delta

during the awake state, but this is not prominent with visual
analysis. Older patients have less prominent posterior dominant
alpha activity. Also, tense patients may have little or no visible
posterior dominant alpha-range activity. This should be
commented on in the report, but not interpreted as an abnormality
in the absence of other findings.
Mengantuk
Patients progress from waking to drowsiness, during which time
there are several changes, including progressive reduction of
muscle artifact, a slight reduction in the posterior rhythm
frequency (usually not more than 1 Hz), anterior widening of the
field of posterior dominant rhythm, and slow horizontal eye
movements (SEM). This is sleep stage 1A. With progression to
stage 1B, there is attenuation then loss of posterior dominant
rhythm. The posterior dominant rhythm is reduced to less than
20% with the appearance of theta.
Vertex waves may be seen in stage 1B, but this is more of a
characteristic of stage 2 sleep. Theta becomes more prominent.
Differentiation of stages lA from 1B is not important for routine
EEG, but is important in sleep studies, as 3 consecutive epochs (1
epoch=30 seconds) of stage IB is considered the onset of sleep

Tidur
Sleep is most easily recognized in stage 2. Stage 2 sleep is
heralded by the presence of sleep spindles, more prominent
vertex waves, and K-complexes, which are longer polyphasic
vertex waves often associated with spindle activity. There is
complete loss of the posterior dominant alpha rhythm. Since
vertex waves may appear in drowsiness and sleep stage 1B, the
main differentiating feature of stage 2 is the appearance of sleep
spindles. Delta begins to appear at this stage.
Stage 2:

Stage 3: Stage 3 sleep is characterized by more delta and

fewer faster frequencies. Delta comprises 20-50% of the record.
Stage 3 sleep is not commonly seen in routine office EEG.
Stage 4: Delta activity predominates in stage 4 sleep, which now
comprises more than 50% of the record. Vertex waves and sleep
spindles are often absent. Stage 4 sleep is rarely seen on routine
office EEG.