This is a workbook that is designed to compliment the LHI EEG Online Board Prep. It also contains 199 EEG sample test questions and answers.
LHI EEG BOARD PREP:
This is not just another EEG book to read. Study at your own pace as you watch Larry thoroughly explain each EEG topic in this online VIDEO course. Your subscription to this course will last 360 days from date of purchase.
This course has been approved for 25 ASET CEUs.
This comprehensive board preparation course will prepare the experienced technologist for 2018 American Board of Electroencephalographic and Evoked Potential Technologists (ABRET®) EEG credential examination.
The EEG ABRET Exam consists of 250 written multiple choice questions. Larry Head Institute’s Board Preparation course follows the ABRET outline.
Pre Study/Patient Preparation
Medical / EEG terminology
Knowledge of HIPPA
Neuroanatomy and neurophysiology
Electrode Placement, properties, and the 10-20 System
Obtaining acceptable impedances
Infection control (patients, equipment, electrodes, etc)
Allergies and sensitivities
Related SDS/OHSA standars
Patient safety/Electrical safety
ABRET Code of Ethics
Elements of a History – Why take a patient history, personal information, EEG ID information, chief complaint, handedness, time of last meal, medications, other diagnostic test results, HV contraindications, skull defects, sleep deprivation, previous EEG results, and specific scenarios as examples
Medical / EEG Terminology – Larry will walk you through the definitions of relevant terms and give examples that will help make the terminology “come alive”, easier to understand and remember. He will cover general medical terms and terminology specific to neurodiagnostics.
Common Medications & Treatments – The more common medications prescribed for neurology patients will be reviewed. Medications and the disorder or disease for which they are used will be described.
Knowledge of HIPPA – Larry will discuss what you need to know to protect the privacy a patient’s health information, what constitutes protected health information and the technologist’s responsibility to their patients.
Neurologic Examination & Disorders – Larry will discuss how to examine the patient’s cerebral function (mental status), cranial nerve function, motor function, sensory function, cerebellar function, reflex status and gait & stance.
Basic Neuroanatomy – Meninges, Reflections, Cerebral hemispheres, Motor and Sensory cortex, Gray and White matter, Primary tracts, Commissures, Lobes, Fissures, Speech areas, Thalamus and Hypothalamus, Basal Ganglia, Internal capsule, Brainstem, Reticular activating system, Cerebellum, Ventricular system, Vascular (arterial) system, and Cranial nerves.
Basic Neurophysiology – Neuron parts and function, Action potential, Resting membrane potential, Depolarization / Repolarization, Sodium-Poatassium pump, Propagation, Neurotransmitter, Synaptic cleft, Synapse, Pre & Postsynaptic membrane, Excitatory Postsynaptic Potential (EPSP), Inhibitory Postsynaptic Potential (IPSP), Absolute Refractory Period, Relative Refractory Period, and EEG Signal).
Electrode Placement & International 10-20 System – Larry will review the proper procedure for measuring and marking the head as well as techniques for quickly calculating head measurements.
Obtaining Acceptable Impedances – We will detail acceptable impedance values and properly balancing the amplifier inputs.
Infection control – We will discuss how to prevent cross contamination between patients and how to clean electrodes between uses. Sources and sites, modes of transmission, standard precautions, non-critical, semi-critical, and critical items specific to EEG, will be discussed thoroughly.
Electrical safety – Under Construction
ABRET Code of Ethics – We will discuss complying with ACNS guidelines, patients’ rights & human dignity, thoroughness in performance of duties & interaction with patients, patient & medical confidentiality, the technologist’s responsibility to remain current in technology & the neurodiagnostic field, the technologist’s responsibility to remain ethical, legal and to not interpret, the technologist’s responsibility to be truthful, cooperative & compliant with ABRET rules & to respect ABRET’s intellectual property, the necessity to report to ABRET any felony convictions, and ABRET’s disciplinary recourse.
Monitoring techniques (age specific, state specific)
Recording strategies (montages, parameter changes)
Digital instrumentation (filters, etc)
Effects of medications on the recording
Activation techniques/contraindications to activation
Identifying, eliminating/monitoring artifacts
Managing clinical events
Sleep stages and patterns
Correlation of history with EEG patients
Normal/abnormal adult EEG
Normal/abnormal pediatric EEG
Normal/abnormal neonatal EEG
ACNS Guidelines and terminology
Electropgraphic correlates to clinical/non-clinical entities
Localization and polarity
Measurement of frequency, voltage, and duration
Waveform analysis & identification
ECI recordings and guidelines
Documentation – We will explain how to properly document instrument settings, artifacts, patient movement & changes in body position, levels of consciousness, and stimulation techniques.
Age-specific considerations – How to deal with neonates, pediatric and the adult patient is imperative. When is the best time to perform the EEG for a neonate? Documentation of gestational, chronological, and conceptional age, notations and observation, modified electrode placement for small head size will be reviewed. Required recording time to include awake and active and quiet sleep stages are considerations for recording neonates. Pediatric considerations include comforting the patient and explaining the procedure in a way to calm a child. Geriatric patients and the mentally impaired present their own set of challenges when recording EEG. This review will address each of these and more.
Coma and altered mental status – Dealing with and recording the EEG on a comatose patient can be challenging. Larry will discuss how the EEG may be helpful in determining the depth and severity of the coma, how the EEG can aid in suggesting a possible cause for the coma, and what the EEG actually displays in the comatose state. Differing levels on consciousness will be reviewed as well as stimulation techniques. Specific patterns such as IRDA, spindle coma, alpha coma, and burst suppression seen during coma will be thoroughly explained.
Basic Recording Strategies (Montages & Parameter Changes) – We will review the various types of bipolar and referential montages, when to select each type, and their advantages & disadvantages. We will also discuss the impact that changing parameters such as sensitivity and filters will have on our recorded data, and times when it is appropriate to adjust the recording parameters.
Digital instrumentation – The different types of filters (HF, LF & Time Constant, 60 Hz) are explained thoroughly. The effect each has on the EEG signal will be reviewed. High pass and low pass filter terminology will be explained. As well as analog vs digital recording, horizontal resolution and vertical resolution
Effects of medications on recording and patients – The more common medications prescribed for neurology patients will be reviewed. Medications, the disorder or disease for which they are used, and their effect on the EEG and the patient will be described in detail.
Activation techniques – Hyperventilation, photic stimulation, and sleep are common activation techniques routinely performed during the EEG test. Larry will describe why and how each is performed, contraindications, artifacts commonly seen, normal and abnormal responses.
Troubleshooting – We will explain how to identify problems, trace the problem to the cause, introduce a troubleshooting checklist and the describe how to properly eliminate and/or monitor problems.
Managing clinical events – How to identify and care for the patient during seizure and cardiac/respiratory arrest is of utmost importance. Follow Larry as he explains how to care for the patient that is having a clinical episode.
Sleep stages and patterns – Larry will move into sleep patterns including stage N1 (alpha attenuation, slow rolling eye movements, POSTS & vertex sharp waves), stage N2 (sleep spindles and K complexes), stage N3 (slow wave sleep) and stage R (rapid eye movement and saw-tooth waves).
Correlation of history with specific EEG patterns (breech, JCD, etc) – Few, but some, EEG patterns are diagnostic. Larry will help you understand how to correlate a patient history with a specific pattern.
Normal Adult, Pediatric, and Neonatal EEG – Larry will review relevant terminology including frequency, voltage, location, symmetry, periodic, variability, duration, morphology, polarity, synchrony and reactivity. He will introduce normal adult EEG patterns including alpha, beta, theta, lambda, wickets, breach rhythm, SREDA, posterior slow waves of youth, Mu rhythm, RMTD, 14 & 6 positive spikes, 6 Hz spike & wave and BETS. Then he will move into sleep patterns including stage N1 (alpha attenuation, slow rolling eye movements, POSTS & vertex sharp waves), stage N2 (sleep spindles and K complexes), stage N3 (slow wave sleep) and stage R (rapid eye movement and saw-tooth waves). EEG waveforms and patterns specific to the pediatric and neonatal patient will be discuss thoroughly. These include for the neonatal EEG the definition of gestational, chronological, and conceptional age, modified electrode placement for a small head circumference, suggested montage, monitoring of non-cerebral parameters, stimulation techniques, documentation, characteristics and assessment of the neonatal EEG during wakefulness, active and quiet sleep, Trace Discontinue, Trace Alternant, and concluding with a detailed review of the neonatal EEG maturation. Pediatric EEG will be reviewed thoroughly. When the alpha rhythm presents, trace alternant, O waves and EEG patterns such as Posterior Slow Wave of Youth, HV Buildup, LAMBDA, POSTS, and Hypnogogic Hypersynchrony will be discussed in detail. Synchrony and symmetry between hemispheres will be reviewed. Sleep spindles, K-complexes will be addressed.
Abnormal EEG – Finally, Larry will review abnormal patterns including background changes, FIRDA, PLEDS, Alpha Coma, Burst Suppression, Herpes Simplex, ECI, delta (monomorphic & polymorphic), OIRDA, BIPLEDS, Triphasic Waves, CJD, 3 Hz Spike & Wave, and Generalized Spike & Wave seen in the adult. Pediatric abnormalities include benign rolandic spikes, absence seizures, Juvenile Myoclonic Epilepsy, Landau-Kleffner Syndrome, West Syndrome and the Hypsarrhythmia EEG pattern, Lennox-Gastaut Syndrome and slow spike and wave, and Sturge-Weber Syndrome are all covered in detail. Each will be reviewed regarding symptoms, medications, and EEG patterns.
Abnormal Neonatal EEG – Under Construction
ACNS Guidelines & Terminology
Electrographic correlates to clinical/non-clinical entities – Recognizing EEG patterns is absolutely necessary. This topic is intermixed with other topics and covered completely.
Measurements of frequency, voltage and duration – Larry will discuss the sensitivity pie and the relationship of voltage, amplitude and sensitivity. Additionally, he will discuss frequency and duration, paper speed, and the measurements, formulas & calculation methods for each. Students will come away with a complete understanding of how to calculate measurements.
Waveform Identification (Normal, Abnormal, Wake and Sleep) – Larry will review relevant terminology including frequency, voltage, location, symmetry, periodic, variability, duration, morphology, phase, synchrony and reactivity. He will introduce normal EEG patterns including alpha, beta, theta, lambda, wickets, breach rhythm, SREDA, posterior slow waves of youth, Mu rhythm, RMTD, 14 & 6 positive spikes, 6 Hz spike & wave and BETS. Then he will move into sleep patterns including stage N1 (alpha attenuation, slow rolling eye movements, POSTS & Vertex sharp waves), stage N2 (sleep spindles and K complexes), stage N3 (slow wave sleep) and stage R (rapid eye movement and saw-tooth waves). Finally, he will review abnormal patterns including background changes, FIRDA, PLEDS, alpha, burst suppression, Herpes Simplex, ECI, delta (monomorphic & polymorphic), OIRDA, BIPLEDS, triphasic waves, CJD, 3 Hz spike & wave, and generalized spike & wave.
Waveform Calculations (amplitude, voltage, duration, frequency and paper speed) – Larry will discuss the sensitivity pie and the relationship of voltage, amplitude and sensitivity. Additionally, he will discuss frequency and duration, paper speed, and the measurements, formulas & calculation methods for each.