ElectroEncephaloGraphy
(EEG)
Dr. Ansa Qaiser
PGR Paeds Med
Ward 20, NHM
By the end of this presentation, participants should be able to:
1. Define what is EEG and its application in pediatric neurology.
2. Understand the basic principles of EEG
3. Identify typical EEG features in common pediatric neurological conditions.
4. Interpret EEG findings in various clinical settings, including epilepsy,
developmental disorders, and sleep disorders.
5. Understand the role of EEG in diagnosing and managing neonatal
encephalopathy and metabolic/genetic disorders.
Electroencephalography (EEG) is a crucial
diagnostic tool used to measure electrical
activity in the brain. In pediatric settings,
EEGs are utilized to diagnose and monitor
various neurological conditions, including
epilepsy, sleep disorders, developmental
anomalies, and encephalopathies.
F=Frontal
Fp=Frontal pole
T=Temporal
C=Central
P=Parietal
O=Occipital
z= central/sagittal plane
Even numbers= Right side
Odd numbers = Left side
• “10” and “20” values correspond with the 10
and 20% values of the distance between
“mastoids” and between nasion and inion,
which are the extreme points.
• “10–20” system consists of 21 electrodes in
total, however, only 19 are placed on the
surface of the scalp, where the 2 are usually
applied on earlobes as reference channels
Frequency Amplitude Prominent Features
in areas
Delta wave 0.5-4 20-200 Occipito- Deep Sleep
Temporal If in awake state,
organic braindamage
Theta wave 4-8 <200 Parieto- Children-Sleep
Temporal Adults-Depression
Alpha wave 8-13 50-100 Parieto- Awake with eyes
Occipital closed, wandering
minds
Beta wave 13-30 5-10 Frontal Attention and
Regions wakeful state, eyes
opened
Break it down into steps:
1. Background activity- gives you an
overall sense of what is going on with the
patient
2. Symmetry- is there any focal changes
seen
3. Stage of Alertness
4. Abnormality- slowing, sharp waves etc
• Normal alpha background activity (>3-4
years)
• No abnormalities (nothing stands out in
the background)
• No changes in EEG provoked by photic,
hyperventilation
• No asymmetry
A 12 year old child presented with
recurrent episodes of flexor jerks of arms
and legs, causing him to fall, mostly
occuring in early morning.
No h/o disturbed cosciousness, he was
aware of the jerky movements. CNS exam
was unremarkable. His EEG showed the
following results.
1. EEG shows symmetrical
wave discharge of ,
usually in the and caudal regions.
stimulation often provokes a
discharge
2. Juvenile Myoclonic Epilepsy
A 10 year old girl presented in OPD with
h/o declining school performance for the
last six months. She had very aggressive
behaviour towards her family and
disturbed sleep. O/E, there was complete
loss of short term memory, and
infrequent abnormal movements of both
arms. Her EEG showed the following
results:
1. EEG sshows characteristic pattern of
and suppression of
complexes.
2. Subacute Sclerosing PanEncephalitis
A 7 year old child had a h/o right sided
focal fits with twisting of the mouth
during sleep. He did not remember
anything in the morning. Birth events are
normal. CNS examination was
unremarkable. His EEG was recorded.
1. EEG shows a left
activity. Spikes are of high voltage.
2. Benign Rolandic Epilepsy (BECTS)
An 8 months old infant presented with
recurrent episodes of flexor spasms
involving the neck, trunk and limbs,
followed by the tonic sustained
contraction of 2-10 seconds. Birth events
were normal. He started sitting at 7
months of age. His EEG was recorded.
1. EEG shows and
abnormal background of
and random slow wave and spike
discharges.
2. Hypsarrythmias, Infantile spasms
A 10 year old child referred by a school
teacher that he often becomes motionless
for 5-10 seconds while attending lectures.
No h/o loss of consciousness and he could
not recall anything. After the episodes,
child resumes his normal activity. His EEG
was done:
1. pattern. Lasting for
less than 3 seconds.
2. Petit mal epilepsy
A 4 year old boy was admitted with
history of high grade fever and 2 episodes
of fits. Family history positive for febrile
fits. EEG was done
1. Normal EEG. No epileptiform activity
seen. Normal background.
Condition EEG findings
Juvenile Myoclonic symmetrical wave discharge of
Epilepsy , usually in the and central regions
SSPE and suppression of complexes.
Benign Rolandic Epilepsy
Infantile spasms and abnormal background of
and random slow wave and spike discharges.
Absence seizures pattern. Lasting for less than 3 seconds.
Encephalopathy Low voltage and slow background
Product A Product B
• Feature 1 • Feature 1
• Feature 2 • Feature 2
• Feature 3 • Feature 3
