10-20 International Electrode Placement Chart

Course introduction:
It is important to have a method to diagnose neuromuscular junction abnormalities in children. The neuromuscular junction in children can be affected by autoimmune myasthenia gravis or congenital abnormalities of the neuromuscular junction. Both conditions are rare in children and often do not present with recognizable clinical stereotypes. Many are treatable once diagnosed. Repetitive nerve stimulation is a well recognized technique but is relatively insensitive. SFEMG offers high levels of sensitivity and is the preferred technique in children. Voluntary SFEMG is rarely possible to do consistently in children. Stimulated SFEMG can with practice be performed on any child from the neonate to the teenager. This presentation describes the use of a modification of StimSFEMG which uses concentric needle electrodes (SPACE).

Learning Objectives:

• Background to the development of the technique of SPACE
• How to perform SPACE successfully in children
• The test characteristics when applied to large numbers of children with suspected Myasthenia

Course introduction:
In this presentation, Dr. Christopher Skidmore will discuss the most common EEG testing modalities, when to utilize each technique, and the limitations for each technique. Combining each technique provides a more detailed understanding of the true seizure generator in individuals being evaluated for epilepsy.

Learning Objectives:

At the conclusion of this seminar the participants will be able to:

• Name the indications for various forms of EEG
• Identify pitfalls of various EEG techniques
• Demonstrate how the various forms of EEG provide complimentary information

CE Credits:

This course is valid for 1.0 Contact Hour ASET CECs

Course introduction: 
During this webinar presentation Dr. Aashit Shah will discuss the EEG recording as an adjunctive tool in the care of patients with epilepsy but that its use, has been limited over the years due to perceived lack of specificity and limited technological capabilities. In last 2 decades, with progress in computer technology and digital EEG recording and analysis, the simultaneous video EEG recording has become a powerful tool in diagnosis and treatment of epilepsy syndromes and surgical treatment of epilepsy. It is also being increasingly used as an adjunct for care of patients where the neurological exam is limited. With increasing knowledge of temporal changes in EEG and analysis of these trends as well as, technological advances in signal processing and remote monitoring, it is becoming an integral part of neurocritical care and in the operating room. The lecture will review digitization of EEG signal and its effects, evolution of long-term EEG and intraoperative monitoring and its current use in neurological/neurosurgical care and will discuss future use of EEG signals in care of various neurological conditions.

Learning Objectives:

• Review evolution of EEG recording and journey from analog to digital EEG
• Review use of video EEG in ambulatory and inpatient setting in care of patients with epilepsy
• Discuss evolution of EEG in coma, SE, and cardiopulmonary arrest
• LTM in ICU and future trends
• EEG and EPs in IOM of neurological function

CE Credits:
This course is valid for 1.0 Contact Hour ASET CECs

Breve Introducción:
El síndrome compartimental intracraneal (SCI) es una entidad que asocia síntomas y signos debido a un aumento de la presión intracraneal (PIC). La hipertensión intracraneal, consecuencia principal del SCI requiere un diagnóstico y tratamiento urgente para prevenir una lesión cerebral irreversible. El traumatismo craneoencefálico (TCE) causa frecuentemente un SCI. Por lo anterior, la monitoría de la PIC adquiere una importancia fundamental en los pacientes con TCE para la detección rápida de eventos nocivos y para una evaluación en tiempo real de la eficacia del tratamiento del SCI.

Objetivos de aprendizaje:

• Identificar y entender el concepto del síndrome de compartimiento intracraneal.
• Correlacionar el concepto del síndrome de compartimiento intracraneal con los conceptos de presión intracraneana e hipertensión intracraneal.
• Identificar la utilidad de los diferentes sistemas de medicion de presion intracraneal y su rol en el manejo del síndrome de compartimiento intracraneal.
• Discutir las propuestas recientes de manejo médico y quirúrgico de la hipertensión intracraneal y el síndrome de compartimiento intracraneal

CE Credits:
El Consejo de Acreditación y Recertificación Médica Voluntaria (CAR) de la Asociación Colombiana de Neurocirugía otorgará a los participantes de este evento 20 créditos de Educación Médica Continuada

Course introduction:
Accurate diagnosis of neonatal seizures is challenging due to the fact that seizures may resemble normal or abnormal neonatal behaviours and many seizures have only subtle clinical signs or are electrographic only. It has been shown that clinical diagnosis is unreliable. Conventional EEG is considered the gold standard for the diagnosis, but it is not available in most NICUs due to lack of on-site specialist support. More commonly used is amplitude-integrated EEG (aEEG) (85% of all NICU’s), which provides a slow trend of brain activity using only a limited number of electrodes. While easier to apply and interpret, aEEG has been shown to miss a significant number of seizures and carries a significant risk of false positive detections. New technology allows to record both EEG and aEEG to be recorded at the same time with remote access for specialist support, providing the best of both worlds for the timely diagnosis of neonatal seizures.

Course Objectives:

• Understand the need for EEG or aEEG in the diagnosis of neonatal seizures.
• To be able discuss the advantages and disadvantages of both techniques.
• Understand the value of using both techniques together.

Course introduction:
Interictal epileptiform discharges are the most commonly used biomarkers for epilepsy, in clinical practice. In skilled hands, they help confirming the diagnosis and provide useful information to classify epilepsy. However, over-interpretation of EEG is the most common cause of misdiagnosis. The operational criteria for IED provide high specificity and sensitivity and contribute to improving the quality of EEG reading in clinical practice.

Learning Objectives:

• At the end of this session the audience will be able to implement the operational criteria for identifying interictal epileptiform discharges.

Course introduction:
EEG source imaging is a clinically validated tool, increasingly used in the presurgical evaluation of patients with drug resistant focal epilepsy. Structured training in advanced signal analysis methods is often missing from the epilepsy and EEG curricula. This session will provide an overview on EEG source imaging, from a clinical perspective.

Learning Objectives:

• At the end of this session the audience will become familiar with the principles of EEG source imaging, its advantages and limitations, and will be able to integrate the results of EEG source imaging into the presurgical evaluation.