EEG

Definition

An electroencephalogram (EEG) is a test to measure the electrical activity of the brain.

Alternative Names

Electroencephalogram; Brain wave test

How the test is performed

Brain cells talk to each other by producing tiny electrical signals, called impulses.

An EEG helps measure this activity. The test is done by a EEG specialist in your doctor's office or at a hospital or laboratory.

You will be asked to lie on your back on a bed or in a reclining chair.

Flat metal disks called electrodes are placed all over your scalp. The disks are held in place with a sticky paste. The electrodes are connected by wires to a speaker and recording machine.

The recording machine changes the electrical signals into patterns that can be seen on a computer. It looks like a bunch of wavy lines.

You will need to lie still during the test with your eyes closed because movement can change the results. But, you may be asked to do certain things during the test, such as breathe fast and deeply for several minutes or look at a bright flashing light.

How to prepare for the test

Wash your hair the night before the test. Do not use any oils, sprays, or conditioner on your hair before this test. If you have a hair weave, you may want to ask your doctor or nurse for special instructions.

Your health care provider may want you to stop taking certain medications before the test. Do not change or stop taking medications without first talking to your health care provider. Bring a list of your medications with you.

Avoid all food and drinks containing caffeine for 8 hours before the test.

Sometimes you may need to sleep during the test, so you may be asked to reduce your sleep time the night before. If you are asked to sleep as little as possible before the test, do not eat or drink any caffeine, energy drinks, or other products that help you stay awake.

How the test will feel

The electrodes may feel sticky and strange on your scalp but should not cause any other discomfort. You should not feel any discomfort during the test.

Why the test is performed

EEG is used to look at your brain activity. It can help diagnose seizures. It may also be used to diagnose or monitor the following health conditions:

• Abnormal changes in body chemistry that affect the brain
• Brain diseases such as Alzheimer's disease
• Confusion
• Head injuries
• Infections
• Tumors

EEG is also used to:

• Evaluate problems with sleep ( sleep disorders)
• Investigate periods of unconsciousness
• Monitor the brain during brain surgery

An EEG may be done to show that the brain has no activity, in the case of someone who is in a deep coma. It can be helpful when trying to decide if someone is brain dead.

EEG cannot be used to measure intelligence.

Normal Values

Brain electrical activity has a certain number of waves per second (frequencies) that are normal for different levels of alertness. For example, brain waves are faster when you are awake, and slower when you are sleeping.

There are also normal patterns to these waves.

What abnormal results mean

Abnormal results on an EEG test may be due to:

• Abnormal bleeding (hemorrhage)
• An abnormal structure in the brain (such as a brain tumor)
• Attention problems
• Tissue death due to a blockage in blood flow (cerebral infarction)
• Drug or alcohol abuse
• Head injury
• Migraines (in some cases)
• Seizure disorder (such as epilepsy or convulsions)
• Sleep disorder (such as narcolepsy)
• Swelling of the brain (encephalitis)

Note: A normal EEG does not mean that a seizure did not occur.

What the risks are

The procedure is very safe. However, the flashing lights or fast breathing (hyperventilation) required during the test may trigger seizures in those with seizure disorders. The health care provider performing the EEG is trained to take care of you if this happens.

It may be difficult to get the paste out of your hair, but it should come out after a few washings with regular shampoo.

Special considerations

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References

Trescher WH, Lesser RP. The Epilepsies. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa: Butterworth-Heinemann; 2008:chap 71.

Krumholz A, Wiebe S, Gronseth G, et al. Practice parameter: evaluating an apparent unprovoked first seizure in adults (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Neurology. 2007;69(21):1991-2007.

Woo Lee J, Khoshbin S. Clinical neurophysiology and electroencephalography. In: Stern TA, Rosenbaum JF, Fava M, et al, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, Pa: Mosby Elsevier; 2008:chap 75.