EEG Machine Guide

EEG Machine Guide: Complete Practical Reference for Pediatric Healthcare | PediaDevices

Professional reference for parents, caregivers, and healthcare professionals

An Electroencephalogram (EEG) machine is a medical device that records the electrical activity of the brain. This non-invasive test helps diagnose and monitor various neurological conditions in children, particularly seizures and epilepsy. The machine uses small electrodes placed on the scalp to detect brain waves and display them as wavy lines on a computer screen.

What is an EEG Machine

An EEG machine measures the brain's electrical signals through electrodes attached to the scalp. Brain cells communicate using electrical impulses, which create patterns that can be recorded and analyzed. The device amplifies these tiny signals (typically 5 to 500 microvolts) and stores them digitally for review by trained specialists.

Main Components

  • Electrodes: Small metal discs (16 to 32 typically) placed on the scalp
  • Amplifier: Increases the strength of brain signals for recording
  • Recording Device: Computer system that stores and displays the data
  • Wires and Cables: Connect electrodes to the recording device
  • Monitoring Screen: Displays brain wave patterns in real-time

Purpose and Medical Uses

EEG machines serve multiple diagnostic and monitoring purposes in pediatric healthcare:

Primary Applications

  • Epilepsy and Seizure Disorders: Diagnose seizure types and monitor treatment effectiveness
  • Seizure Classification: Determine specific seizure patterns to guide medication selection
  • Brain Development Assessment: Evaluate developmental delays or abnormalities
  • Sleep Disorders: Diagnose conditions affecting sleep patterns and quality
  • Head Injury Evaluation: Assess brain function after trauma
  • Behavioral Issues: Investigate causes of attention problems or behavioral changes
  • Brain Infections: Monitor conditions like encephalitis or meningitis
  • Brain Tumors: Help identify abnormal brain activity patterns

Where EEG Machines are Used

  • Hospital neurology departments and epilepsy monitoring units
  • Outpatient clinics and diagnostic centers
  • Pediatric intensive care units (PICU) and neonatal intensive care units (NICU)
  • Sleep study laboratories
  • Home settings (ambulatory EEG)
  • Emergency departments for acute neurological assessment

Types of EEG Testing

Different EEG types serve specific diagnostic needs. The choice depends on the child's symptoms, suspected condition, and how frequently events occur.

Type Duration Best For
Routine EEG 20-30 minutes to 2 hours Initial screening, baseline brain activity assessment
Sleep EEG Several hours Capturing abnormalities during sleep, sleep disorders
Prolonged EEG Several hours to days Capturing infrequent events, detailed monitoring
Ambulatory EEG 24-72 hours Recording at home during daily activities
Video EEG Hours to days Correlating physical symptoms with brain activity
Dense Array EEG Varies High-resolution brain mapping (up to 256 electrodes)

Routine EEG

The most common type, performed in a clinic or hospital setting. Takes 30 minutes to 2 hours. Child lies still while brain activity is recorded during waking and sleeping states. May include activation procedures like flashing lights or rapid breathing.

Ambulatory EEG

Portable EEG device worn in a small backpack for 1-3 days at home. Allows recording during normal daily activities. More convenient and less expensive than hospital monitoring. Child or caregiver presses an event button when symptoms occur.

Video EEG Monitoring

Combines brain wave recording with synchronized video recording. Typically done in hospital epilepsy monitoring units for several days. Helps distinguish epileptic seizures from other conditions. Essential for surgical planning in drug-resistant epilepsy.

Dense Array EEG

Uses many more electrodes (64-256) for detailed brain mapping. Provides higher spatial resolution. Often used for surgical planning or research. Application is faster and more comfortable as electrodes fit in a cap.

How to Use: Step-by-Step Procedure

Before the Test: Proper preparation ensures accurate results and a smooth procedure.

Preparation Phase

  1. Hair Care: Wash child's hair the night before with regular shampoo. Do not use conditioner, oils, gels, sprays, or styling products. Remove hair extensions. Keep long hair loose, not braided or tied up.
  2. Dietary Restrictions: Avoid caffeine for 8-12 hours before test (coffee, tea, chocolate, caffeinated sodas). Do not let child fast as low blood sugar affects results. Give regular meals unless specifically instructed otherwise.
  3. Medication Management: Continue all regular medications unless doctor advises stopping specific ones. Bring a complete medication list with dosages and timing.
  4. Sleep Preparation: If sleep recording needed, child may need to sleep less the night before (sleep deprivation). Follow specific instructions from medical team.
  5. Clothing Choice: Dress child in comfortable, button-front or zip-front clothing. Avoid pull-over shirts that must go over the head.
  6. Comfort Items: Bring favorite toy, stuffed animal, blanket, or pacifier for comfort. For longer tests, bring quiet activities, books, or approved electronic devices.

During the Procedure

  1. Patient Identification: Technologist verifies child's identity and checks for allergies or skin sensitivities.
  2. Head Measurement: Technologist measures head and marks electrode positions with washable marker. Standard positions follow the 10-20 system for consistent placement.
  3. Skin Preparation: Marked areas are rubbed with mildly abrasive cream or gel to improve electrode contact and reduce signal interference.
  4. Electrode Application: Electrodes attached using conductive paste or adhesive glue. For longer studies, collodion (medical glue) may be used with quick-drying air compressor. Process takes 30-60 minutes depending on cooperation.
  5. Connection and Testing: Electrodes connected to EEG machine. Technologist checks all connections and signal quality before starting recording.
  6. Baseline Recording: Child asked to lie still with eyes open, then closed. Relaxation is important for clear readings.
  7. Activation Procedures: May include hyperventilation (deep breathing for 3 minutes), photic stimulation (looking at flashing lights with eyes closed), and attempted sleep if applicable.
  8. Monitoring: Parent or caregiver can stay in room. Technologist monitors recording quality and child's comfort throughout procedure.

After the Test

  1. Electrode Removal: Technologist disconnects wires and removes electrodes. Adhesive washed off with warm water and washcloth.
  2. Hair Cleaning: Most glue removed at facility, but some may remain. Additional washing at home with regular shampoo usually needed. May take 2-3 washes to remove all residue.
  3. Skin Check: Examine scalp for any red areas or irritation. Report concerns to medical team.
  4. Return to Activities: Child can resume normal activities immediately unless specific restrictions given.
  5. Results: Neurologist reviews recording and sends report to ordering physician, typically within a few days. Follow-up appointment scheduled to discuss findings.

Safety Precautions and Important Warnings

Critical Safety Points: EEG is very safe, but awareness of these precautions ensures optimal outcomes.

Electrical Safety

  • No Shock Risk: Electrodes only record electrical activity. They do not deliver electricity to the patient. There is no risk of electric shock from properly functioning equipment.
  • Proper Grounding: Ensure EEG machine is plugged into properly grounded electrical outlets. Equipment should have regular maintenance and safety checks.
  • Multiple Device Caution: When child is connected to multiple medical devices, avoid double-grounding which can create electrical hazards.

Seizure Considerations

  • Potential Seizure Triggering: In children with seizure disorders, flashing lights or hyperventilation during the test may trigger a seizure. This is sometimes intentional for diagnostic purposes.
  • Medical Supervision: Technologists and medical staff are trained to recognize and respond to seizures immediately. Emergency medications and protocols are always available.
  • Safety Precautions: Child may need to wear a helmet during video EEG monitoring in hospital to prevent injury if seizures occur.

Skin and Scalp Care

  • Pressure Points: Prolonged monitoring can cause skin pressure from electrodes. Use flat-rimmed electrodes and proper positioning to minimize pressure.
  • Skin Irritation: Mild redness or irritation from adhesives or abrasion usually resolves within 24 hours. Report persistent redness, open areas, or signs of infection.
  • Neonatal Precautions: For newborns, avoid harsh chemicals. Use disc electrodes with paste instead of collodion due to fume sensitivity.
  • Head Wrapping: If head is wrapped, use breathable gauze. Should be able to fit two fingers under wrap to prevent excessive pressure.

Infection Control

  • Electrode Cleaning: Reusable electrodes must be properly disinfected between patients according to established protocols. Single-use disposable electrodes reduce infection risk.
  • Skin Preparation: When skin is abraded for better electrode contact, electrodes become semi-critical items requiring high-level disinfection.
  • Standard Precautions: Healthcare workers follow standard infection prevention protocols during application and removal.

Ambulatory EEG Specific Precautions

  • Water Restriction: Child cannot bathe, shower, or get head wet during recording period. Sponge baths only below the neck.
  • Activity Limitations: Avoid strenuous activities that could dislodge electrodes. No swimming or contact sports.
  • Wire Protection: Keep recording device in provided backpack. Prevent pulling or tension on wires.
  • Event Documentation: Caregiver must accurately log all events and symptoms with time stamps. Press event button immediately when episodes occur.

General Safety Tips

For Safe EEG Testing:
  • Inform medical team of all allergies, especially to adhesives or latex
  • Report any skin conditions or scalp wounds before electrode application
  • Keep child calm and comfortable to reduce movement artifacts
  • Follow all pre-test instructions carefully
  • Ask questions if any part of the procedure is unclear
  • For video EEG, stay visible on camera for accurate event correlation
  • Never remove electrodes or disconnect equipment without staff approval

Equipment Maintenance and Care

For Healthcare Facilities

  • Regular Maintenance: Schedule routine equipment checks including electrical safety testing, calibration verification, and amplifier performance assessment.
  • Electrode Care: Clean and disinfect reusable electrodes immediately after use. Follow manufacturer guidelines and infection control protocols. Inspect for damage before each use.
  • Cable Management: Check wires and cables regularly for fraying or damage. Replace damaged cables promptly to prevent signal problems.
  • Software Updates: Keep recording software current with manufacturer updates for optimal performance and security.
  • Storage: Store equipment in clean, dry environment away from extreme temperatures. Keep electrodes organized to prevent tangling.
  • Battery Maintenance: For portable units, maintain batteries according to manufacturer specifications. Test battery life regularly.
  • Documentation: Maintain logs of maintenance, repairs, and equipment performance issues.

For Home Ambulatory EEG

  • Device Protection: Keep recording device in provided case or backpack at all times. Protect from drops or impacts.
  • Electrode Protection: Head may be wrapped with gauze and soft cap to protect electrode wires. Do not remove wrapping.
  • Clean Environment: Keep device away from dirt, moisture, and extreme temperatures.
  • Battery Monitoring: Ensure device stays charged if it has rechargeable batteries. Follow charging instructions carefully.
  • Event Button: Keep event button accessible. Test it works at start of recording period.
  • Return Instructions: Return equipment as instructed. Report any technical problems during recording period.

Troubleshooting Common Issues

Problem Solution
Loose electrode Contact technologist immediately for re-application
Skin irritation Report to medical staff. May need electrode repositioning
Recording device alarm Check connections. Contact monitoring team if alarm persists
Low battery Connect to charger if portable. Alert staff immediately
Child discomfort Use distraction techniques. Request break if needed for routine EEG

Frequently Asked Questions

Is the EEG test painful?
No. The test is completely painless. Electrodes only record brain activity and do not cause any discomfort. Some children may find the electrode application slightly uncomfortable, but it does not hurt.
Can my child get an electric shock from the EEG?
No. There is absolutely no risk of electric shock. The electrodes only record electrical signals from the brain. They do not deliver any electricity to your child.
Will my child's head need to be shaved?
No. The head does not need to be shaved for any type of EEG. Electrodes attach to the scalp surface without removing hair.
How long do EEG results take?
A neurologist reviews the recording, which typically takes a few days. Results are sent to the ordering physician who will discuss findings with you at a follow-up appointment. Urgent findings are communicated immediately.
Can I stay with my child during the test?
Yes. One parent or guardian is typically allowed to stay in the room throughout the procedure. Your presence helps keep your child calm and comfortable.
What if my child cannot stay still?
For very young or uncooperative children, test timing may be adjusted to capture sleep periods. Sedation is rarely used as it can affect results. Distraction techniques and breaks may help. For infants, swaddling may be used.
Will the glue come out of my child's hair?
Yes. Most glue is removed at the facility. Remaining residue washes out with regular shampooing at home. It may take 2-3 washes with warm water to remove all adhesive completely.
Can EEG detect all brain problems?
No. EEG shows electrical activity patterns but cannot detect structural problems like tumors or strokes. It is excellent for diagnosing seizures and electrical abnormalities but may need to be combined with other tests like MRI or CT scans.
What if the routine EEG is normal but seizures continue?
A normal routine EEG does not rule out epilepsy. Abnormal activity may not occur during the short recording time. Doctor may recommend longer monitoring like ambulatory EEG or video EEG to capture events.
Can my child eat before an EEG?
Yes, children should eat normally before an EEG. Low blood sugar can affect results. Only restriction is avoiding caffeine for 8-12 hours before the test. Follow any specific instructions from your medical team.
Is ambulatory EEG as accurate as hospital monitoring?
Ambulatory EEG provides high-quality brain wave recordings comparable to hospital equipment. However, it may be harder to capture events on video, and medications cannot be safely reduced at home. Choice depends on individual circumstances.
Can seizures be triggered during the EEG?
Yes, activation procedures like flashing lights or rapid breathing may trigger seizures in susceptible children. This is sometimes done intentionally for diagnostic purposes. Medical staff are prepared to manage seizures safely if they occur.

Additional Important Information

Who Interprets EEG Results

EEG recordings are analyzed by specialists with specific training:

  • Pediatric Neurologists: Doctors specializing in childhood brain and nervous system conditions
  • Epileptologists: Neurologists with additional expertise in seizure disorders
  • Clinical Neurophysiologists: Specialists trained in brain electrical activity interpretation

Cost Considerations

EEG costs vary significantly by type and location:

  • Routine outpatient EEG is generally the least expensive option
  • Ambulatory EEG costs less than multi-day hospital monitoring
  • Video EEG in epilepsy monitoring units is most comprehensive but most costly
  • Insurance coverage varies; verify benefits and pre-authorization requirements beforehand

Technologist Training and Certification

EEG technologists undergo specialized training to perform tests safely and effectively:

  • Completion of accredited EEG technology programs
  • Certification through organizations like the American Board of Registration of Electroencephalographic and Evoked Potential Technologists (ABRET)
  • Ongoing continuing education to stay current with advances in EEG technology and techniques

Disclaimer

This guide is intended for informational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read in this guide. PediaDevices is not responsible for any actions taken based on the information provided herein.

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