Intro to EEG

Nicholas J. Beimer, MD
Lead placement

10-20 system
 Common montages

longitudinal bipolar transverse

Normal 20 year old
Normal 20 year old
Normal 20 year old
Normal 20 year old
 Frequency ranges of EEG

• 0.5-3.999 Hz Delta
• 4-7.999 Hz Theta
• 8-12.999 Hz Alpha
• >13 Hz Beta

* Difference between alpha frequency and

alpha rhythm
Normal 20 year old

10 Hz PDR
(posterior dominant rhythm)
 Normal PDR by age

• 3-4 Hz 3-4 months

• 5-6 Hz 1 year
• 7 Hz 2 years
• 8 Hz 3 years
• 8.5 Hz 8-10 years
Normal
Normal

Eye closure
Normal
Normal

Alpha squeak: transient

increase in alpha
rhythm after eye blink
Normal
Normal

Lambda waves: sharply

contoured, occipital,
occur with visual
scanning
Normal
Normal

POSTS: positive occipital

sharp transients of sleep
Normal
 Normal

Sleep spindles: about 13 Hz,

0.5 sec burst, characteristic of
stage II sleep
Normal
 Normal

K complex: Negative sharp

wave, then slower positive
component, associated with
spindles
Normal
 Normal
Vertex waves
Normal
Normal

Posterior slow waves

of youth (prominent
in ages 3-10)
If this is normal, how old
is the patient?
 Normal
75 year old

Age >65:
• Focal temporal delta slowing
once every several minutes
• Increase in frontal beta
• PDR still 8.5 hz or greater
Normal
 Normal
Hypnagogic
hypersynchrony: 4-5
Hz rhythmic bursts in
young children, a
marker of drowsiness
and transitional sleep
 Normal

Rapid lateral eye

movements
Normal

Sawtooth waves: theta frequency,

sawtooth shape
REM
Provocative measures
Provocative measures
Photic driving
 Provocative measures

Photic driving
 Provocative measures

Slowing with
hyperventilation
Benign variants
Benign variants

Mu: frontocentral alpha

rhythm that disappears when
pt. opens and closes
contralateral hand
Benign variants
Benign variants

RMTTD: rhythmic temporal

theta of drowsiness
Benign variants
Benign variants

BETS: benign epileptiform

transients of sleep
Benign variants
Benign variants
Wicket spikes
Benign variants
14 and 6 positive bursts

• 14 and/or 6 Hz
• 6 Hz more common in early
childhood
• 14 Hz more common in late
childhood/adolescence
Benign variants
14 and 6 positive bursts

• 14 and/or 6 Hz
• 6 Hz more common in early
childhood
• 14 Hz more common in late
childhood/adolescence