Recommendations for the Practice of Clinical Neurophysiology:

Guidelines of the International Federation of Clinical Physiology (EEG Suppl. 52)

Editors: G. Deuschl and A. Eisen
q 1999 International Federation of Clinical Neurophysiology. All rights reserved.
Published by Elsevier Science B.V. 21

Chapter 1.5

A glossary of terms most commonly used by clinical

electroencephalographers and proposal for the report form
for the EEG ®ndings

S. Noachtar* (Germany), C. Binnie (UK), J. Ebersole (USA), F. MauguieÁre (France),

A. Sakamoto (Brazil) and B. Westmoreland (USA)

This glossary includes the terms most commonly The EEG report should follow a standard
used in clinical EEG. It is based on the previous protocol that includes a description, and an inter-
proposal (Chatrian et al. 1974) and is limited to the pretation of the EEG. The interpretation of the EEG
terms necessary to describe the EEG and to requires knowledge of the patient's age and clinical
generate the EEG report. All EEG phenomena condition during the EEG, particularly the level of
should be described as precisely as possible in consciousness/vigilance and the ability to co-
terms of frequency, amplitude, phase relation, operate. The EEG interpretation summarizes the
waveform, localization, quantity, and variability results of the EEG and gives a clinical interpreta-
of these parameters (Brazier et al. 1961). The tion in light of the diagnosis and the questions of the
description should be independent of the recording referring physician. The terminology of the EEG
parameters such as ampli®cation, paper speed, interpretation should follow common neurological
montages, and computer program/display. Biolo- and clinical practice and use terms understandable
gical and technical artifacts that interfere with an to other physicians not necessarily specialized in
adequate EEG interpretation should either be elimi- EEG. A proposal for a report form is given in
nated or, if this is not possible, be noted in the Appendix A.
description.

* Correspondence to: Dr. S. Noachtar, Department of

Neurology, University of Munich, Marchionini Strasse 15,
D-81377 Munich (Germany).
22

Glossary
Absence: Use of term discouraged when relative mental inactivity. Blocked or attenuated by
describing EEG patterns. Terms suggested, when- attention, especially visual, and mental effort.
ever appropriate: spike-and-slow-wave complex; 3/ Comment: use of term alpha rhythm must be
s spike-and-slow-wave complex; sharp-and-slow- restricted to those rhythms that ful®ll these criteria.
wave complex. Activities in the alpha band which differ from the
Activation procedure: (1) Any procedure alpha rhythm as regards their topography and/or
designed to enhance or elicit normal or abnormal reactivity, should either have speci®c appellations
EEG activity, especially paroxysmal activity. (for instance: the mu [m] rhythm) or should be
Examples: hyperventilation, photic stimulation, referred to as rhythms of alpha frequency, or
sleep, injection of convulsant drugs. (2) Induction alpha activity.
of an EEG pattern consisting of a low voltage Alpha variant rhythms: Certain characteristic
record which becomes apparent upon blocking of EEG rhythms that are recorded most prominently
EEG rhythms by physiological or other stimuli such over the posterior regions of the head and differ in
as electrical stimulation of the brain (use in this frequency but resemble in reactivity the alpha
meaning discouraged). rhythm. Comment: often at a supra or sub-harmonic
Active electrode: Use of term discouraged. of alpha frequency may occur when no alpha
Comment: all electrodes may be active including rhythm is visible (see: fast alpha variant rhythm;
all cephalic references. The use of this term may be slow alpha variant rhythm.
acceptable when recording brain signals with a non- Alpha wave: Wave with duration of 1/8±1/13 s.
cephalic reference electrode. Alphoid rhythm: Use of term discouraged.
Activity, EEG: An EEG wave or sequence of Term suggested: alpha rhythm.
waves. Amplitude: Voltage of EEG waves expressed in
After-discharge: (1) EEG seizure pattern microvolts (mV). Measured peak-to-peak.
following single or repetitive electrical stimulations Comment: size of an EEG wave is dependent
of a discrete area of the brain via cortical or intra- upon signal voltage divided by the pen writer or
cerebral electrodes. (2) Burst of rhythmic activity display sensitivity. EEG depicts the difference in
following a transient such as an evoked potential or potential between electrode pairs. It is therefore
a spike. dependent on the method of derivation and has no
Aliasing: Distortion of the EEG signal, which simple relationship to actual amount of cerebral
occurs when the signal is digitized at less than activity. EEG waves recorded from the surface of
half the highest frequency present (see Nyquist the head are attenuated and distorted by intervening
theorem). structures, particularly the skull.
Alpha band: Frequency band of 8±13 Hz. Greek Analog-to-digital conversion (AD conversion):
letter: a . Transformation of a continuous, analog EEG into
Alpha rhythm: Rhythm at 8±13 Hz occurring its digital representation (a discontinuous series of
during wakefulness over the posterior regions of discrete amplitude measurements). AD conversion
the head, generally with maximum amplitudes is characterized by the sampling rate, which is the
over the occipital areas. Amplitude varies but is number of times per second at which the signal is
mostly below 50 mV in the adult. Best seen with transformed into numbers, and the amplitude reso-
the eyes closed and during physical relaxation and lution, the number of numerical values which can
 23

be distinguished within the dynamic range of the not meet the criteria of 3 per second spike-and-
system (usually expressed as the number of binary slow-wave complex.
digits). Augmentation: Increase in amplitude of elec-
Aperiodic: Applies to: (1) EEG waves or trical activity.
complexes occurring in a sequence at an irregular Average potential reference: Average of the
rate, (2) EEG waves or complexes occurring inter- potentials of all or many EEG electrodes, used as
mittently at irregular intervals. a reference. Synonym: Goldman±Offner reference
Apotentiality, record of cerebral: Use of term (use discouraged). Term suggested: common
discouraged. Term suggested: record of electrocer- average reference.
ebral inactivity.
Application, electrode: The process of estab- Background activity: Any EEG activity repre-
lishing mechanical ®xation and electrical connec- senting the setting in which a given normal or
tion between an electrode and the subject's scalp or abnormal pattern appears and from which such
brain. pattern is distinguished. Comment: not a synonym
Arrhythmic activity: A sequence of waves of of any individual rhythm such as the alpha rhythm.
inconstant period (see rhythm). Background slow activity: The frequency of the
Arousal: Change from a lower to a higher level background rhythm is below the normal value.
of arousal as manifest in EEG. Band: Portion of EEG frequency spectrum, i.e.
Array, electrode: A regular arrangement of delta, theta, alpha, beta bands.
electrodes over the scalp or brain or within the Bandwidth, EEG channel: Range offrequencies
brain substance. between which the response of an EEG channel is
Artifact: (1) A potential difference due to an within stated limits. Determined by the frequency
extracerebral source, recorded in EEG tracings. response of the ampli®er, pen writer, if any, and the
(2) A modi®cation of the EEG caused by extracer- frequency ®lters used. Comment: the manner in
ebral factors such as alterations of the media which the EEG channel bandwidth is speci®ed by
surrounding the brain, instrumental distortion or different manufacturers is not yet standardized. For
malfunction, and operational errors. instance, a bandwidth of 1±70 Hz in a given instru-
Asymmetry: Unequal amplitude of EEG activ- ment may indicate that frequencies of 1 and 70 Hz are
ities over homologous areas on opposite sides of the attenuated by 30% (3 dB) or another stated percent,
head. with intermediate frequencies being less attenuated.
Asynchrony: The non-simultaneous occurrence Basal electrode: Any electrode located in proxi-
of EEG activities over regions on the same or oppo- mity to the base of the skull (see foramen ovale
site sides of the head. electrode, nasopharyngeal electrode; sphenoidal
Attenuation: (1) Reduction in amplitude of EEG electrode).
activity. May occur transiently in response to Baseline: (1) Strictly: line obtained when an
physiological or other stimuli, such as electrical identical voltage is applied to the two input term-
stimulation of the brain, or result from pathological inals of an EEG ampli®er or when the instrument is
conditions (see blocking). (2) Reduction of sensi- in the calibrate position but no calibration signal is
tivity of an EEG channel, i.e. decrease of output applied. (2) Loosely: imaginary line corresponding
de¯ection during operation of sensitivity or ®lter to the approximate mean values of the EEG activity
controls. Customarily expressed as relative reduc- assessed visually in an EEG derivation over a
tion of sensitivity at certain stated frequencies (see period of time.
sensitivity; high frequency ®lter; low frequency Benign epileptiform discharges of childhood:
®lter). Regional or multiregional sharp waves, which are
Atypical spike-and-slow-wave complex: normally followed by a negative slow wave with
Paroxysms consisting of a sequence of spike-and- lower amplitude than the negative peak of the sharp
slow-wave complexes that occur bilaterally but do wave and which typically show a bipolar distribu-
24

tion with a positive sink in the mid frontal region. Bisynchronous: Abbreviation for bilaterally
These sharp waves often have a multiregional synchronous (use discouraged).
distribution and are easy to recognize by their Blacklead: Use of term discouraged. Term
typical morphology. If they occur in the centrotem- suggested: input terminal 1.
poral region, they are also called ``Rolandic Blocking: (1) Apparent, temporary obliteration
spikes''. They typically increase during sleep and of EEG rhythms in response to physiological or
tend to appear in series. other stimuli such as electrical stimulation of the
Benign epileptiform transient of sleep (BETS): brain (see attenuation). (2) A condition of
Small sharp spikes (SSS) of very short duration and temporary unresponsiveness of the EEG ampli®er,
low amplitude, often followed by a small theta caused by major overload. Manifested initially by
wave, occurring in the temporal regions during extreme, ¯at-topped trace excursion(s) lasting up to
drowsiness and light sleep. This pattern is of little a few seconds (see overload, clipping).
clinical signi®cance (see small sharp spikes). Brain wave: Use of term discouraged. Term
Beta band: Frequency band from 14 to 40 Hz. suggested: EEG wave.
Greek letter: b (see gamma band). Brushes, delta: see delta brushes.
Beta rhythm: In general: any EEG rhythm Buffer ampli®er: An ampli®er, generally with a
between 14 and 40 Hz. Most characteristically: a voltage gain of 1, a high input impedance, and a low
rhythm from 14 to 40 Hz recorded over the fronto- output impedance, used to isolate the input signal
central regions of the head during wakefulness. from the loading effects of an immediately
Amplitude of frontocentral beta rhythm varies but following circuit. In some electroencephalographs,
is mostly below 30 mV. Blocking or attenuation by each input is connected to a buffer ampli®er located
contralateral movement or tactile stimulation is in the jack box to reduce cable artifact and inter-
especially obvious in electrocorticograms. Other ference.
beta rhythms are most prominent in other locations Build-up: Colloquialism. Frequently employed
or are diffuse. to describe progressive increase in voltage of the
Bilateral: Involving both sides of the head. EEG or appearance of waves of increasing ampli-
Bin width: Time, usually expressed in micro- tude, frequently associated with decrease in
seconds, elapsing between two successive sampling frequency during hyperventilation. Sometimes
points in digital EEG (see digital EEG). applied to hyperventilation or seizure discharges
Biological calibration: See common EEG input (use discouraged).
test. Burst: A group of waves which appear and
Biparietal hump: Use of term discouraged. disappear abruptly and are distinguished from back-
Term suggested: vertex sharp transient. ground activity by differences in frequency, form
Biphasic wave: Use of term discouraged. Term and/or amplitude. Comments: (1) term does not
suggested: diphasic wave. imply abnormality. (2) Not a synonym of paroxysm
Bipolar derivation: (1) Recording from a pair of (see paroxysm).
electrodes. (2) Method of organizing the linkages of Burst suppression: Pattern characterized by
electrodes to recording channels (see bipolar bursts of theta and/or delta waves, at times inter-
montage). mixed with faster waves, and intervening periods of
Bipolar montage: Multiple bipolar derivations, low amplitude (below 20 mV). Comment: EEG
with no electrode being common to all derivations. pattern that indicates either severe brain dysfunc-
In most instances, bipolar derivations are linked, tion or is typical for some anesthetic drugs at
i.e. adjacent derivations from electrodes along the certain levels of anesthesia.
same line of electrodes have one electrode in
common, connected to the input terminal 2 of one C/s: See cycles per second. Equivalent: Hz.
ampli®er and to the input terminal 1 of the Calibration: (1) Procedure of testing and
following ampli®er (see reference montage). recording the responses of EEG channels to voltage
 25

differences applied to the input terminals of their Example:

respective ampli®ers. Comment: DC (usually) or
AC voltages of magnitude comparable to the ampli- amplification; differential 100; 000
ˆ
tudes of EEG waves are used in this procedure. (2) amplification; common mode 1
The procedure of testing the accuracy of paper
ˆ 100; 000 : 1
speed by means of a time marker (see common
EEG input test). Common mode signal: Common component of
Cap, head: A cap that is ®tted over the head to the two signals applied to the two input terminals of
hold pad electrodes in position. a differential EEG ampli®er. Comment: in EEG
recording, external capacitative interference
frequently occurs as a common mode signal.
Channel: Complete system for the detection, Common reference electrode: A reference elec-
ampli®cation and display of potential differences trode connected to the input terminal 2 of several or
between a pair of electrodes. Comment: analog all EEG ampli®ers.
electroencephalographs generally have several Common reference montage: Several referen-
EEG channels. Digital EEG machines simulate a tial derivations sharing a single reference electrode
multichannel display by tracing several voltage (see referential derivation, reference electrode).
time plots on a visual display. Complex: A sequence of two or more waves
Circumferential bipolar montage: A montage having a characteristic form or recurring with a
consisting of linked bipolar derivations in a circular fairly consistent form, distinguished from back-
shape around the head. Commonly bilateral long- ground activity.
itudinal temporal electrode chains are linked Contingent negative variation: An event
together. related slow potential elicited in the interval
Clipping: Distortion of EEG waves which makes following a premonitory stimulus and a second
them appear ¯at-topped in the write-out or display. stimulus to which the subject is required to make
Caused by overload. a voluntary response. It comprises a progressive
Closely spaced electrodes: Additional scalp negative-going change maximal at the vertex.
electrode placed at half distance between the stan- Abbreviation: CNV.
dard electrodes of the ten±twenty system (see ten± Continuous slow activity: Slow activity that
ten system, standard electrode, special electrode). occurs continuously is non-responsive to external
Comb rhythm: Use of term discouraged. Term stimuli and clearly exceeds the amount considered
suggested: mu (m) rhythm. physiologically normal for the patient's age. As a
Common average reference: See average rule, it is irregular (polymorphic) and lies within the
potential reference. frequency range of delta/theta waves (see intermit-
Common EEG input test: Procedure in which tent slow activity).
the same pair of EEG electrodes is connected to the Coronal bipolar montage: A montage
two input terminals of all channels of the electro- consisting of derivations from pairs of electrodes
encephalograph. Synonym: biological calibration. along coronal (transverse) linear arrays. Synonym:
Comment: used as adjunct to calibration procedure transverse bipolar montage.
(see calibration). Cortical electrode: Electrode applied directly
Common mode rejection: A characteristic of upon or inserted in the cerebral cortex.
differential ampli®ers whereby they provide mark- Cortical electroencephalogram: See electro-
edly reduced ampli®cation of common mode corticogram.
signals, compared to differential signals. Expressed Cortical electroencephalography: See electro-
as common mode rejection ratio, i.e. ratio of corticography.
ampli®cations of differential and common mode Corticogram: Use discouraged. Term
signals. suggested: electrocorticogram.
26

Corticography: Term preferred: electrocortico- Desynchronized: Use of term discouraged when

graphy. describing EEG pattern (see low voltage EEG).
Cycle: The complete sequence of potential Diffuse: Occurring over large areas of one or
changes undergone by individual components of a both sides of the head (see generalized).
sequence of regularly repeated EEG waves or Differential ampli®er: An ampli®er whose
complexes. output is proportional to the voltage difference
Cycles per second: Unit of frequency. Abbrevia- between its two input terminals. Comment: electro-
tion: c/s. Equivalent: Hertz (Hz). encephalographs make use of differential ampli®ers
in their input stages.
Differential signal: Difference between two
Deep sleep: Non-REM sleep stages 3 and 4 unlike signals applied to the respective two input
(Rechtschaffen and Kales 1968). terminals of a differential EEG ampli®er.
Delta brushes: Rhythmic spindle-like activity Digital EEG: (1) The representation of an analog
(10±25 mV) superimposed on 0.3±1.5 Hz slow EEG signal by a series of numbers related to
waves (25±250 mV) in preterm infants. successive measurements of the magnitude of the
Delta band: Frequency band under 4 Hz. Greek signal at equal time intervals. (2) The practice of
letter: d . Comment: for practical purposes lower electroencephaolography using digital representa-
frequency limit is 0.5 Hz, as DC potential differ- tion of EEGs.
ences are not monitored in conventional EEGs. Diphasic wave: Complex consisting of two wave
Delta brush: Delta wave with superimposed fast components developed on alternate sides of the
activity. Comment: normal ®nding in neonatal baseline.
EEG. Dipole: A theoretical point-like EEG source
Delta rhythm: Rhythm under 4 Hz. produced by a separation of negative and positive
Delta wave: Wave with duration over 1/4 s. charge. Comment: commonly used to describe a
Depression: Use of term discouraged when cortical source that generates an EEG ®eld in
describing EEG patterns. which both negative and positive maxima can be
Depth electrode: Electrode (usually multicon- recorded, e.g. the ``horizontal dipole`` of so called
tact electrode) implanted within the brain Rolandic spikes.
substance. Dipolar: An EEG voltage ®eld that displays both
Depth electroencephalogram: Record of elec- negative and positive maxima.
trical activity of the brain by means of electrodes Direct coupled ampli®er: An ampli®er in which
implanted within the brain substance itself (see successive stages are connected (coupled) by
stereotactic [stereotaxic] depth electroencephalo- devices. the performance of which is not frequency
gram). dependent.
Depth electroencephalography: Technique of Direct current ampli®er: An ampli®er that is
recording depth electroencephalograms (see stereo- capable of magnifying DC (zero frequency)
tactic [stereotaxic] depth electroencephalography). voltages and slowly varying voltages.
Derivation: (1) The process of recording from a Disk electrode: Metal disk attached to the scalp
pair of electrodes in an EEG channel. (2) The EEG with an adhesive such as collodion or paste.
record obtained by this process. Discharge: Interpretive term commonly used to
Desynchronization: Use of term discouraged designate epileptiform and seizure patterns (see
when visually describing EEG change. Terms epileptiform pattern, seizure pattern).
suggested: blocking, attenuation. Exception: the Disorganization: Gross alteration in frequency,
term desynchronization is acceptable when form, topography and/or quantity of physiologic
describing attenuation of a frequency band based EEG rhythms in (1) an individual record, relative
on power spectra analysis of the EEG signal (for to previous records in the same subject or the
instance ''event-related desynchronization''). rhythms of homologous regions on the opposite
 27

side of the head or (2) relative to ®ndings in normal Electrode resistance: Total effective resistance
subjects of similar age and similar state of vigi- to direct current (DC), through the interface
lance. between an EEG electrode and the scalp or
Distortion: An instrument-induced alteration of brain. Measured between pairs of electrodes or,
wave form (see artifact). in some electroencephalographs, between each
Duration: (1) The interval from beginning to end individual electrode and all the other electrodes
of an individual wave or complex. Comment: the connected in parallel. Expressed in ohms (gener-
duration of the cycle of individual components of a ally kilo-ohms, kV ). Comment: measurement of
sequence of regularly repeating waves or electrode resistance with DC currents results in
complexes is referred to as the period of the wave varying degrees of electrode polarization (see elec-
or complex. (2) The time that a sequence of waves trode impedance).
or complexes or any other distinguishable feature Electroencephalogram: Record of electrical
lasts in an EEG record. activity of the brain taken by means of electrodes
Dysrhythmia: Use of term discouraged. placed on the surface of the head, unless otherwise
speci®ed. Abbreviation: EEG.
Earth connection: Term discouraged. Synonym: Electroencephalograph: Instrument employed
ground connection (preferred term). to record electroencephalograms.
ECoG: Abbreviation for electrocorticogram and Electroencephalographic: Appertaining to
electrocorticography. bioelectrical recording, irrespective of the method
EEG: Abbreviation for electroencephalogram, employed (in the present context, EEG, ECoG,
electroencephalography and electroencephalo- SEEG, etc.)
graphic. Electroencephalography: (1) The science
Electrocorticogram: Record of EEG activity relating to the electrical activity of the brain. (2)
obtained by means of electrodes applied directly The practice of recording and interpreting electro-
over or inserted in the cerebral cortex. Abbrevia- encephalograms. Abbreviation: EEG.
tion: ECoG. Comment: electrocorticograms can be Electrogram: Use of term discouraged.
performed intraoperatively and extraoperatively. Electrography: Use of term discouraged.
Electrocorticography: Technique of recording Encoches frontal: Frontal sharp waves in
electrical activity of the brain by means of elec- newborns.
trodes applied over or implanted in the cerebral Epidural electrode: Electrode located over the
cortex. Abbreviation: ECoG. Comment: electrocor- dural covering of the cerebrum.
ticography can be performed intraoperatively and Epileptic pattern: Use of term discouraged.
extraoperatively. Term suggested: epileptiform pattern.
Electrode, EEG: A conducting device applied Epileptiform pattern: Synonym: epileptiform
over or inserted in a region of the scalp or brain. discharge, epileptiform activity. Describes transi-
Electrode impedance: Total effective resistance ents distinguishable from background activity,
to alternating current (AC), arising from ohmic with a characteristic spiky morphology, typically,
resistance and reactance. Measured between pairs but neither exclusively nor invariably, found in
of electrodes or, in some electroencephalographs, interictal EEGs of people with epilepsy.
between each individual electrode and all the other Epoch: A period of time in an EEG record. Dura-
electrodes connected in parallel. Expressed in ohms tion of epochs is determined arbitrarily. Example:
(generally kilo-ohms, kV). Comments: (1) over the power spectra were calculated from 10-s epochs.
EEG frequency range, because the capacitance Equipotential: Applies to regions of the head or
factor is small, electrode impedance is usually electrodes that are at the same potential at a given
equal to electrode resistance. (2) Not a synonym instant in time. Synonym: isopotential line.
of input impedance of EEG ampli®er (see electrode Event-related (slow) potential: Applied mainly
resistance; input impedance). to those evoked potentials elicited by cognitive
28

activities. Abbreviation: ERP (see evoked poten- Fourteen- and 6-Hz positive burst: Burst of
tial). arch-shaped waves at 13±17 Hz and/or 5±7 Hz but
Evoked potential: Wave or complex elicited by most commonly at 14 and or 6 Hz seen generally over
and time-locked to a physiological or non-physio- the posterior temporal and adjacent areas of one or
logical stimulus or event, the timing of which can both sides of the head during sleep. The sharp peaks
be reliably assessed, for instance, an electrical of its component waves are positive with respect to
stimulus, delivered to a sensory receptor or nerve other regions. Amplitude varies but is generally
or applied directly to a discrete area of the brain or a below 75 mV. Comments: (1) best demonstrated by
movement (myoclonus). Comment: computer referential recording using contralateral earlobe or
summation techniques are especially suitable for other remote, reference electrodes. (2) This pattern is
detecting these and other event-related potentials of no established clinical signi®cance.
from the surface of the head. Fourteen- and 6-Hz positive spikes: Synonym:
Evoked response: Tautology. Use of term 14- and 6-Hz positive burst.
discouraged. Term suggested: evoked potential. Frequency: Number of complete cycles of repe-
Extracerebral potential: Any potential that titive waves or complexes in 1 s. Measured in
does not originate in the brain, referred to as an cycles per second (c/s) or Hertz (Hz). Comment:
artifact in EEG. May arise from electrical interfer- the term Hz seems appropriate when applied to
ence external to the subject and recording system, sinusoidal waves such as alpha activity, but seems
the subject, the electrodes and their connections to inappropriate when applied to complex wave forms
the subject and the electroencephalograph, and the such as spike-and-slow-wave.
electroencephalograph itself (see artifact). Frequency response: see bandwidth, low
frequency response, high frequency response.
Fast activity: Activity of frequency higher than Frequency response curve: A graph depicting
alpha, i.e. beta and gamma activity. the relationships between output trace de¯ection or
Fast alpha variant rhythm: Characteristic ampli®er output and input frequency, for a parti-
rhythm at 14±20 Hz, detected most prominently cular setting of low and high frequency ®lters.
over the posterior regions of the head. May alter- Frequency spectrum: Range of frequencies
nate or be intermixed with alpha rhythm. Blocked composing the EEG. Divided into 5 bands termed
or attenuated by attention, especially visual, and delta, theta, alpha, beta and gamma (see delta, theta,
mental effort. alpha, beta, gamma bands).
Fast wave: Wave with duration shorter than Frontal intermittent rhythmic delta activity:
alpha waves, i.e. under 1/13 s. Fairly regular, approximately sinusoidal or saw-
Flat EEG: Use of term discouraged (see low tooth waves, mostly occurring in bursts at 1.5±2.5
voltage EEG; record of electrocerebral inactivity). Hz over the frontal areas of one or both sides of the
Focal: Limited to a small area of the brain, i.e. head. Abbreviation: FIRDA. Comment: most
recorded in one or two intracranial electrodes (see commonly associated with unspeci®ed encephalo-
regional, multifocal). pathy.
Focus: A limited region of the scalp, cerebral
cortex, or depth of the brain displaying a given G1: Abbreviation for grid 1 (use of term discour-
EEG activity, either normal or abnormal. aged).
Foramen ovale electrode: A multicontact elec- G2: Abbreviation for grid 2 (use of term discour-
trode bundle inserted through the foramen ovale to aged).
lie in proximity to the parahippocampal gyrus. Gain: Ratio of output signal voltage to input
Comment: used for presugical assessment of signal voltage of an EEG channel. Example:
epilepsy of suspected mesial temporal origin.
output voltage 10 V
Form. Shape of a wave. Synonym: wave form, Gain ˆ ˆ ˆ 1; 000; 000
morphology. input voltage 10 mV
 29

Often expressed in decibels (dB), a logarithmic ®lter, this attenuation is expressed as percent reduc-
unit. Example: a voltage gain of 10 ˆ 20 dB, of tion in output trace de¯ection at a given frequency,
1000 ˆ 60 dB, of 1,000,000 ˆ 120 dB (see sensi- relative to frequencies unaffected by the ®lter, i.e.
tivity). in the mid-frequency band of the channel.
Gamma band: Frequency band above 40 Hz. Synonym: low pass ®lter. Comment: at present
Greek letter: b (see beta band). Comment: practi- high frequency ®lter designations and their signi®-
cally, most electroencephalographs use trace cance are not yet standardized for instruments of
writers that appreciably attenuate frequencies different manufactures. For instance, for a given
higher than 70 Hz. The customary use of relatively instrument, a position of the high frequency ®lter
slow paper speeds or time scales further limits the control designated as 70 Hz may indicate a 30% (3
electroencephalographer's ability to resolve dB), or other stated percent, reduction in sensitivity
visually waves of frequencies higher than 40 Hz. at 70 Hz, compared to the sensitivity, for example,
The graphic resolution of computer displays may at 10 Hz.
also limit the visual appreciation of higher frequen- High frequency response: Sensitivity of an
cies. However, this does not justify limiting unduly EEG channel to relatively high frequencies. Deter-
the high frequency response of the EEG channels, mined by the high frequency response of the ampli-
for EEG waves include transients such as spikes ®er, pen writer, if any, and the high frequency ®lter
and sharp waves with components at frequencies used. Expressed as percent reduction in output trace
above 50 Hz (see beta rhythm) (not a synonym). de¯ection at certain speci®c high frequencies, rela-
Gamma rhythm: An EEG rhythm above 40 Hz. tive to other frequencies in the mid-frequency band
Comment: most commonly recorded with intracra- of the channel.
nial electrodes. High pass ®lter: Synonym: low frequency ®lter.
Generalization: Propagation of EEG activity Hyperexcitability, neuronal: Use of term
from limited areas to all regions of the head. discouraged when describing EEG patterns.
Generalized: Occurring over all regions of the Hypersynchrony: Use of term discouraged
head, usually with a frontal maximum, rarely with when describing EEG patterns.
an occipital maximum. Hyperventilation: Deep and regular respiration
Goldman±Offner reference: Use of term performed for a period of several minutes. Used as
discouraged. Term suggested: average potential activation procedure. Synonym: overbreathing (see
reference. activation).
Grand mal: Use of term discouraged. Hypsar rhythmia: Pattern consisting of diffuse
Grid 1: Use of term discouraged. Term high voltage (.300 mV) irregular slow waves inter-
suggested: input terminal 1. spersed with multiregional spikes and sharp waves
Grid 2: Use of term discouraged. Term over both hemispheres.
suggested: input terminal 2. Hz: Abbreviation for Hertz. Equivalent: cycles
Ground connection: Conducting path between per second (c/s).
the subject and the electroencephalograph, and the
electroencephalograph and earth. Synonym: earth Impedance meter: An instrument used to
connection. measure impedance (see electrode impedance).
Inactive electrode: Use of term discouraged (see
Harness, head: A combination of straps ®tted reference electrode) (not a synonym).
over the head to hold pad electrodes in position. Inactivity, record of electrocerebral: Absence
Hertz: Unit of frequency. Abbreviation: Hz. over all regions of the head of identi®able electrical
Synonym: cycles per second (c/s). activity of cerebral origin, whether spontaneous or
High frequency ®lter: A circuit that reduces the induced by physiological stimuli or pharmacolo-
sensitivity of the EEG channel to relatively high gical agents. Comment: determination of electro-
frequencies. For each setting of the high frequency cerebral inactivity requires stringent technical
30

precautions. Tracings of electrocerebral inactivity Input voltage: Potential difference between the
should be clearly distinguished from low voltage two input terminals of a differential EEG ampli®er.
EEGs and records displaying delta activity of low Inter-electrode distance: Spacing between pairs
amplitude (see low voltage EEG). Synonym: elec- of electrodes. Comment: distances between adja-
trocerebral silence (use of term discouraged). cent electrodes placed according to the standard
Independent (temporally): Synonym: asyn- 10±20 system or more closely spaced electrodes
chronous. are frequently referred to as short or small inter-
Index: Percent of time an EEG activity is present electrode distances (10±10 system). Larger
in an EEG sample. Example: alpha index. distances such as the double or triple distance
Indifferent electrode: Use of term discouraged. between standard electrode placements are often
Term suggested: reference electrode (not a termed long or large inter-electrode distances.
synonym). Interhemispheric derivation: Recording
In-phase discrimination: Use of term discour- between a pair of electrodes located on opposite
aged. Term suggested: common mode rejection sides of the head.
(not a synonym). Intermittent slow activity: A slow activity that
In-phase signals: Waves with no phase differ- occurs intermittently and is not caused by drowsi-
ence between them (see common mode signal) ness. Intermittent slow can be irregular or rhyth-
(not a synonym). mical (see continuous slow activity).
Input: The signal fed into an EEG ampli®er (see Intracerebral electrode: Synonym: depth elec-
input terminal 1; input terminal 2). trode.
Input terminal 1: The input terminal of the Intracerebral electroencephalogram:
differential EEG ampli®er at which negativity, rela- Synonym: depth electroencephalogram.
tive to the other input terminal, produces an upward Irregular: Applies to EEG waves and complexes
trace de¯ection. Synonyms: ``grid 1'' (G1), black of inconstant period and/or uneven contour.
lead (use discouraged) (see polarity convention). Isoelectric: (1) The record obtained from a pair
Comment: the connection of an electrode to the of equipotential electrodes (see equipotential). (2)
input terminal 1 of the EEG ampli®er is represented Use of term discouraged when describing record of
in diagrams as a solid line. electrocerebral inactivity (see inactivity, record of
Input terminal 2: The input terminal of the electrocerebral).
differential EEG ampli®er at which negativity, Isolated: Occurring singly.
relative to the other input terminal, produces a
downward trace de¯ection. Synonyms: ``grid 2'' K complex: A burst of somewhat variable
(G2), white lead (use discouraged) (see polarity appearance, consisting most commonly of a high
convention). Comment: the connection of an elec- voltage negative slow wave followed by a smaller
trode to the input terminal 2 of the EEG ampli®er positive slow wave frequently associated with a
is represented in diagrams as a dotted or dashed sleep spindle. Amplitude is generally maximal in
line. the frontal vertex. K complexes occur during non-
Input circuit: System consisting of the EEG REM sleep, apparently spontaneously, or in
electrodes and intervening tissues, the electrode response to sudden sensory stimuli, and are not
leads, jack box, input cable, and electrode selectors. speci®c for any individual sensory modality (see
Input impedance: Impedance that exists vertex sharp transient).
between the two inputs of an EEG ampli®er. Kappa rhythm: (Use of term discouraged).
Measured in ohms (generally mega-ohms, MV ) Rhythm consisting of bursts of alpha or theta
with or without the additional speci®cation of frequency occurring over the temporal areas of
input shunt capacitance (measured in picofarads, the scalp of subjects engaged in mental activity.
pF). Comment: not a synonym of electrode impe- Comments: (1) best recorded between electrodes
dance. located lateral to the outer canthus of each eye.
 31

(2) The cerebral origin of this rhythm is considered Comment: at present low frequency ®lter designa-
unproven. It is most probably an ocular artifact tions and their signi®cance are not yet standardized
caused by discrete lateral oscillations of the eyes. for instruments of different manufacturers. For
instance, in a given instrument, a low frequency
Lambda wave: Diphasic sharp transient occur- ®lter setting designated 1 Hz may indicate a 30%
ring over the occipital regions of the head of waking (3 dB), or other stated percent, reduction in sensi-
subjects during visual exploration. The main tivity at 1 Hz, compared to the sensitivity, for
component is positive relative to other areas. example, at 10 Hz. The same position of the low
Time-locked to saccadic eye movement. Amplitude frequency ®lter setting may also be designated by
varies but is generally below 50 mV. Greek letter: the time constant.
l. Low frequency response: Sensitivity of an EEG
Lambdoid wave: Use of term discouraged. Term channel to relatively low frequencies. Determined
suggested: positive occipital sharp transient of by the low frequency response of the ampli®er and
sleep (POSTS). by the low frequency ®lter (time constant) used.
Laplacian montage: Montage that can be used Expressed as percent reduction in output trace
in digital EEG recordings and consists of a mathe- de¯ection at certain stated low frequencies, relative
matical transformation involving the second spatial to other frequencies in the mid-frequency band of
derivative; the Laplacian of the potential may be the channel (see low frequency ®lter, time
approximated by using the average of all neigh- constant).
boring electrodes as a reference for each site or Low pass ®lter: Synonym: high frequency ®lter.
electrode. Montage used for localization of focal Low voltage EEG: A waking record character-
abnormalities on digital EEG (see average potential ized by activity of amplitude not greater than 20 mV
reference). over all head regions. With appropriate instru-
Larval spike-and-slow-wave: Use of term mental sensitivities this activity can be shown to
discouraged. Term suggested: 6-Hz spike-and- be composed primarily of beta, theta and, to a lesser
slow-wave. degree, delta waves, with or without alpha activity
Lateralized: Involving mainly the right or left over the posterior areas. Comments: (1) low voltage
side of the head (see unilateral; regional). EEGs are susceptible to change under the in¯uence
Lead: Strictly: wire connecting an electrode to of certain physiological stimuli, sleep, pharmacolo-
the electroencephalograph. Loosely: synonym of gical agents and pathological processes. (2) They
electrode. should be clearly distinguished from tracings of
Light sleep: Non-REM sleep stages 1 and 2 electrocerebral inactivity and low voltage fast
(Rechtschaffen and Kales 1968). activity.
Linkage: The connection of a pair of electrodes Low voltage fast activity: Low voltage fast
to the two respective input terminals of a differen- activity refers to the fast, and often recruiting,
tial EEG ampli®er (see derivation). activity which can be recorded at the onset of an
Longitudinal bipolar montage: A montage ictal discharge, particularly in invasive EEG
consisting of derivations from pairs of electrodes recording of a seizure.
along longitudinal, usually antero-posterior, arrays. Low voltage fast EEG: Use of term discour-
Low frequency ®lter: A circuit that reduces the aged. Term suggested: low voltage EEG.
sensitivity of the EEG channel to relatively low
frequencies. Synonym: high pass ®lter. For each Machine, EEG: Use of term discouraged. Term
position of the low frequency ®lter control, this suggested: electroencephalograph.
attenuation is expressed as percent reduction of Map, isopotential: Synonym: diagram of equi-
output trace de¯ection at a given stated frequency, potential lines. Graphic display of equipotential
relative to frequencies unaffected by the ®lter, i.e. lines of a potential. The maximum amplitude of
in the mid-frequency band of the channel. the potential is 100% and the fall-off of the poten-
32

tial is shown in arbitrary steps of, for example, 10% Term suggested: reference electrode (not a
of the maximum amplitude. synonym).
Monomorphic: Use of term discouraged when Noise, EEG channel: Small ¯uctuating output of
describing EEG patterns. an EEG channel recorded when high sensitivities
Monophasic wave: Wave developed on one side are used, even if there is no input signal. Measured
of the baseline. in microvolts (mV), referenced to the input.
Monopolar: Use of term discouraged. Term Non-cephalic reference: Reference electrode
suggested: referential. that is not on the head.
Monorhythmic: Use of term discouraged when Non-REM sleep: Term summarizing all sleep
describing EEG patterns. stages except REM-sleep (see quiet sleep).
Monorhythmic sinusoidal delta activity: Use Notch ®lter: A ®lter that selectively attenuates a
of term discouraged (see delta rhythm; frontal very narrow frequency band, thus producing a sharp
(occipital) intermittent rhythmic delta activity). notch in the frequency response curve of an EEG
Montage: The particular arrangement by which channel. A 60- (50) Hz notch ®lter is used to
a number of derivations are displayed simulta- provide attenuation of 60 (50) Hz interference
neously in an EEG record. under extremely unfavorable technical conditions,
Morphology: (1) the study of the form of EEG such as, for instance, recordings in intensive care
waves. (2) The form of EEG waves. units.
Multifocal: More than two or more spatially Nyquist theorem: Accurate digital representa-
separated foci (see focal, regional, multiregional). tion of an EEG signal requires that the sampling
Mu rhythm: Rhythm at 7±11 Hz, composed of rate is at least twice the highest frequency of the
arch-shaped waves occurring over the central or signal, i.e. a frequency of 50 Hz requires at least a
centroparietal regions of the scalp during wakeful- sampling rate of 100 Hz. Comment: sampling at
ness. Amplitude varies but is mostly below 50 mV. twice Nyquvist frequency ensures only accurate
Blocked or attenuated most clearly by contralateral representation of frequency content. Tolerable
movement, thought of movement, readiness to reproduction of waveforms requires 5 samples per
move or tactile stimulation. Greek letter: m. Syno- wave for the fastest components present.
nyms: arceau, wicket, comb rhythms (use discour-
aged). Occipital intermittent rhythmic delta activity:
Multiple spike-and-slow-wave complex: A Fairly regular or approximately sinusoidal waves,
sequence of two or more spikes associated with mostly occurring in bursts at 2±3 Hz over the occi-
one or more slow waves. Synonym: polyspike- pital areas of one or both sides of the head. Abbre-
and-slow-wave complex (preferred term). viation: OIRDA. Frequently blocked or attenuated
Multiple spike complex: A sequence of two or by opening the eyes.
more spikes. Synonym: polyspike complex Ohmmeter: An instrument used to measure
(preferred term). resistance (see electrode resistance).
Multiregional: Three and more regional foci Organization: The degree to which physiologic
(see regional). EEG rhythms conform to certain ideal characteris-
tics displayed by a majority of subjects in the same
age group, without personal or family history of
Nasopharyngeal electrode: Rod electrode intro- neurologic and psychiatric diseases, or other
duced through the nose and placed against the naso- illnesses that might be associated with dysfunction
pharyngeal wall with its tip lying near the body of of the brain. Comments: (1) the organization of
the sphenoid bone. physiologic EEG rhythms progresses from birth to
Needle electrode: Small needle inserted into the adulthood. (2) Poor organization of EEG rhythms
subdermal layer of the scalp. such as the alpha rhythm does not necessarily imply
Neutral electrode: Use of term discouraged. abnormality.
 33

Out-of-phase signals: Two waves of opposite or semiperiodical fashion. They have either a
phases (see differential signal; phase reversal) (not regional or a lateralized distribution. They may
a synonym). also occur independently over both hemispheres.
Output voltage: The voltage across the writer/ The epileptiform discharges often have multiple
trace of an EEG channel. phases and a complex morphology. The main
Overbreathing: Synonym: hyperventilation. component is negative.
Overload: Condition caused by applying voltage Petit mal: Use of term discouraged when
differences which are larger than the channel is describing EEG patterns. Terms suggested, when-
designed for or set to handle to the input terminals ever appropriate: 3 per second spike-and-slow-
of an EEG ampli®er. Causes clipping of EEG wave complex, atypical spike-and-slow-wave
waves and/or blocking of the ampli®er, depending complex, sharp-and-slow-wave complex.
on its magnitude (see clipping, blocking). Petit mal variant: Use of term discouraged
when describing EEG patterns. Terms suggested
Pad electrode: Metal electrode covered with a whenever appropriate: atypical spike-and-slow-
cotton or felt and gauze pad, held in position by a wave complex, sharp-and-slow-wave complex.
head cap or harness. Phantom spike-and-wave: Use of term discour-
Paper speed: Velocity of movement of EEG aged. Term suggested: 6/s spike-and-slow-wave.
paper. Expressed in centimeters per second (cm/s) Phantom spike-and-slow-wave: Use of term
or millimeters per second (m/s). discouraged. Term suggested: 6/s spike-and-slow-
Paroxysm: Phenomenon with abrupt onset, rapid wave.
attainment of a maximum, and sudden termination; Phase: (1) Time or polarity relationships
distinguished from background activity. Comment: between a point on a wave displayed in a derivation
commonly used to refer to epileptiform patterns and and the identical point on the same wave recorded
seizure patterns (see epileptiform pattern, seizure simultaneously in another derivation. (2) Time or
pattern). angular relationships between a point on a wave
Paroxysmal fast: Fast frequencies in the beta and the onset of the cycle of the same wave. Usually
range occurring in trains (see paroxysm, low expressed in degrees or radians.
voltage fast activity). Phase reversal: Simultaneous trace de¯ections
Pattern: Any characteristic EEG activity. in opposite directions from two or more channels.
Peak: Point of maximum amplitude of a wave. Assuming a single generator, a phase reversal is
Pen galvanometer: Synonym: pen writer. due to the same (or at least similar) signal being
Pen motor: Synonym: pen writer. simultaneously applied to the input terminal 2 of
Pen writer: A writer using ink delivered by a one differential ampli®er and to the input terminal
pen. Synonym: pen galvanometer, pen motor. 1 of the other ampli®er. Comment: (1) this
Period: Duration of complete cycle of individual phenomenon is rarely observed in scalp EEGs,
component of a sequence of regularly repeated but is common in intracranial recordings. (2)
EEG waves or complexes. Comment: the period When observed in two linked bipolar derivations,
of the individual components of an EEG rhythm phase reversal indicates that the potential ®eld is
is the reciprocal of the frequency of the rhythm. maximal or minimal at or near the electrode
Periodic: Applies to: (1) EEG waves or common to such derivations. In a referential deri-
complexes occurring in a sequence at an approxi- vation a phase reversal indicates that the reference
mately regular rate. (2) EEG waves or complexes electrode is neither maximum nor minimum for
occurring intermittently at approximately regular the signal. (3) A phase reversal in a referential
intervals, generally of one to several seconds. recording, when assessed using mapping of the
Periodic lateralized epileptiform discharges potential ®elds, indicates that the source is located
(PLEDs): PLEDs are sharp transients such as beneath the zero potential line at a depth that can
sharp waves or spikes, which repeat in a periodical be calculated by modeling (see phase reversal,
34

bipolar montage, referential montage, differential Polarity convention: International agreement

ampli®er, dipole). whereby differential EEG ampli®ers are
Photic driving: Physiologic response consisting constructed so that negativity at the input terminal
of rhythmic activity elicited over the posterior 1 relative to the input terminal 2 of the same ampli-
regions of the head by repetitive photic stimulation ®er produces an upward trace de¯ection. Comment:
at frequencies of about 5±30 Hz. Comments: (1) this convention is contrary to that prevailing in
term should be limited to activity time-locked to some other biological and non-biological ®elds.
the stimulus and of frequency identical or harmoni- Polarity, EEG wave: Sign of potential differ-
cally related to the stimulus frequency. (2) Photic ence existing at a given time between an electrode
driving should be distinguished from the visual affected by a given potential change and another
evoked potentials elicited by isolated ¯ashes of electrode not appreciably, or less, affected by the
light or ¯ashes repeated at very low frequencies. same change (see polarity convention). Comment:
Photic stimulation: Delivery of intermittent the apparent ``polarity`` of an EEG wave is depen-
¯ashes of light to the eyes of a subject. Used as dent upon the potential difference between two
EEG activation procedure. Synonym: intermittent electrodes.
photic stimulation (IPS). Polygraphic recording: Simultaneous moni-
Photic stimulator: Device for delivering inter- toring of multiple physiological measures such as
mittent ¯ashes of light. Synonym: stroboscope (use the EEG, respiration, electrocardiogram, electro-
discouraged). myogram, eye movement, blood pressure, oxygen
Photoconvulsive response: Synonym: photopar- saturation, and leg movements, etc.
oxysmal response (preferred term). Polymorphic activity: Use of term discouraged
Photomyoclonic response: Synonym: photo- when describing EEG pattern.
myogenic response (preferred term). Polyphasic wave: Wave consisting of two or
Photomyogenic response: A response to inter- more components developed on alternating sides
mittent photic stimulation characterized by the of the baseline (see diphasic wave, triphasic wave).
appearance in the record of brief, repetitive Polyrhythmic activity: Use of term discouraged
muscular artifacts (spikes) over the anterior regions when describing EEG pattern.
of the head. These often increase gradually in Polysomnography: Polygraphic recording of
amplitude as stimuli are continued and cease sleep (see polygraphic recording).
promptly when the stimulus is withdrawn. Polyspike-and-slow-wave complex: Synonym:
Comment: this response is frequently associated multiple spike-and-slow-wave complex (term
with ¯utter of the eyelids and vertical oscillations discouraged).
of the eyeballs and sometimes with discrete jerking Polyspike complex: Synonym: multiple spike
mostly involving the musculature of the face and complex (term discouraged).
head. Preferred to synonym: photomyoclonic Positive occipital sharp transient of sleep
response. (POSTS): Sharp transient maximal over the occi-
Photoparoxysmal response: Abnormal re- pital regions, positive relative to other areas, appar-
sponse to intermittent photic stimulation character- ently occurring spontaneously during sleep. May be
ized by spike-and-slow-wave and polyspike-and- single or repetitive. Amplitude varies but is gener-
slow-wave complexes. Responses are graded from ally below 50 mV.
occipital spikes time-locked to the ¯ashes to gener- Positive occipital spike-like wave of sleep: Use
alized epileptiform discharges which may outlast of term discouraged. Term suggested: positive occi-
the stimulus by a few seconds. Comment: only pital sharp transient of sleep (POSTS).
the generalized spike-and-wave response shows a Potential: (1) Strictly: voltage. (2) Loosely:
strong association with epilepsy, particularly if it is synonym of wave.
self-sustaining and continues after the stimulus. Potential ®eld: Amplitude distribution of an
Preferred to synonym: photoconvulsive response. EEG wave at the surface of the head or cerebral
 35

cortex or in the depth of the brain, measured at a EEG ampli®ers is referred to as a common refer-
given instant in time. Represented in diagrams by ence electrode.
equipotential lines (see isopotential map). Referential derivation: Recording from a pair
Projected patterns: Abnormal EEG activities of electrodes consisting of an exploring electrode
believed to result from a disturbance at a site generally connected to the input terminal 1 and a
remote from the recording electrodes. Description reference electrode usually connected to the input
of speci®c EEG patterns preferred. terminal 2 of an EEG ampli®er (see reference elec-
Provocation procedure: Use of term discour- trode, referential montage, common reference
aged. Term suggested: activation. montage).
Pseudoperiodic: Use of term discouraged. Term Referential montage: A montage consisting of
suggested: quasiperiodic. referential derivations. Comment: a referential
Psychomotor variant: Use of term discouraged montage in which the reference electrode is
when describing EEG pattern. Term suggested: common to multiple derivations is referred to as a
rhythmic temporal theta burst of drowsiness. common reference montage (see referential deriva-
tion).
Quantity: Amount of EEG activity with respect Reformatting: Transformation of digitized EEG
to both number and amplitude of waves. into different montages. Reformatting requires that
Quasiperiodic: Applies to EEG waves or the raw EEG signal is recorded to a common refer-
complexes that occur at intervals and only approach ence electrode. Only those electrodes can be
regularity. included in the reformatting montages which are
connected to ampli®er input 1.
RC coupled ampli®er: Abbreviation for resis- Regional: EEG activity that is limited to a region
tance±capacitance coupled ampli®er. of the scalp or recorded in 3 or more electrodes in
Reactivity: Susceptibility of individual rhythms intracranial recordings (see focal, multiregional).
or the EEG as a whole to change following sensory Regular: Applies to waves or complexes of
stimulation or other physiologic actions. approximately constant period and relatively
Record: The end product of the EEG recording uniform appearance.
process. REM: Rapid eye movements.
Recording: (1) The process of obtaining an EEG REM atonia: Reduction of tonic muscle activity
record. Synonym: tracing. (2) The end product of during REM sleep.
the EEG recording process, most commonly traced REM sleep: Sleep stage characterized by low
on paper or digital storage. Synonyms: record, amplitude mixed frequency EEG activity, episodic
tracing. bursts of predominantly horizontal rapid eye move-
Reference electrode: (1) In general: any elec- ments (REM) and reduction of axial tonic muscle
trode against which the potential variations of activity; frequently associated with dreams; phasic
another electrode are measured. (2) Speci®cally: a muscle activity, saw-tooth waves and changes in
suitable reference electrode is any electrode custo- respiration may occur. Synonym: paradoxical
marily connected to the input terminal 2 of an EEG sleep, desynchronized sleep, dream sleep (use of
ampli®er and placed so as to minimize the likeli- terms discouraged) (see active sleep, non-REM
hood of pick-up of the same EEG activity recorded sleep).
by an exploring electrode, usually connected to the Resistance±capacitance coupled ampli®er: An
input terminal 1 of the same ampli®er, or of other ampli®er in which successive stages are connected
activities. Comments: (1) Whatever the location of (coupled) by networks consisting of capacitors and
the reference electrode, the possibility that it might resistors. Abbreviation: RC coupled ampli®er.
be affected by appreciable EEG potentials should Resolution: The resolution of an AD converter
always be considered. (2) A reference electrode (see digital EEG) is speci®ed in binary digits or
connected to the input terminal 2 of all or several ``bits''. For example, a dynamic range of ^1023
36

mV (a total span of 2046 mV), converted at 12-bit electroencephalography should be referred to

resolution, will allow the digitized signal to take on simply as electroencephalography (EEG).
values every 0.5 mV. Secondary bilateral synchrony: Synonym:
Rhythm: EEG activity consisting of waves of secondary generalization. Spreading of an initially
approximately constant period. focal (regional) epileptiform discharge to become
Rhythm en arceau: Use of term discouraged. generalized. Comment: secondary bilateral
Term suggested: mu (m) rhythm. synchrony frequently occurs from midline frontal
Rhythm of alpha frequency: (1) In general: any generators.
rhythm in the alpha band. (2) Speci®cally: term SEEG: Abbreviation for stereotactic (stereo-
should be used to designate those activities in the taxic) depth electroencephalogram and electroence-
alpha band which differ from the alpha rhythm as phalography.
regards their topography and/or reactivity and do Seizure pattern, EEG: Phenomenon consisting
not have speci®c appellations (such as mu rhythm) of repetitive EEG discharges with relatively abrupt
(see alpha rhythm). onset and termination and characteristic pattern of
Rhythmic temporal theta burst of drowsiness: evolution lasting at least several seconds. These
Characteristic burst of 4±7 Hz waves frequently EEG patterns are seen during epileptic seizures.
notched by faster waves, occurring over the Frequent interictal epileptiform discharges are
temporal regions of the head during drowsiness. usually not associated with clinical seizures and
Synonym: psychomotor variant pattern (use thus should be differentiated from electroencepha-
discouraged). Comment: this is a pattern of drowsi- lographic seizure patterns. The component waves
ness that is of no clinical signi®cance. or complexes vary in form, frequency, and topo-
Run: Colloquialism. Use of term discouraged. graphy. They are generally rhythmic and frequently
Term suggested: montage. display increasing amplitude and decreasing
frequency during the same episode. When focal in
onset, they tend to spread subsequently to other
Saw-toothed bursts: Temporal sharp transients areas. Comment: EEG seizure patterns unaccompa-
in preterm infants occurring in burst of 3±8 sharp, nied by clinical epileptic manifestations detected by
rhythmic waves at 4±8 Hz, often with high voltage the EEG technician should be referred to as
(100±200 mV). Synonym: premature temporal ``subclinical''.
theta. Sensitivity: Ratio of input voltage to output trace
Saw-tooth waves. Vertex negative 2±5 Hz de¯ection in an EEG channel. Sensitivity is
waves occurring in series during REM sleep. measured in microvolts per millimeter (mV/mm).
Scalp electrode: Electrode held against, attached Example:
to, or inserted in the scalp.
Scalp electroencephalogram: Record of elec- input voltage 50 mV
trical activity of the brain by means of electrodes Sensitivity ˆ ˆ
output trace deflection 10 mm
placed on the surface of the head. The term should
be used only to distinguish between scalp and other
ˆ 5 mV=mm
electroencephalograms such as depth electroence-
phalograms. In all other instances, a scalp electro- Sharp wave: A transient, clearly distinguished
encephalogram should be referred to simply as an from background activity, with pointed peak at a
electroencephalogram (EEG). conventional paper speed or time scale and duration
Scalp electroencephalography: Technique of of 70±200 ms, i.e. over 1/4±1/5 s approximately.
recording scalp electroencephalograms. Term Main component is generally negative relative to
should be used only to distinguish between this other areas. Amplitude varies. Comments: (1)
and other recording techniques such as depth elec- term should be restricted to epileptiform discharges
troencephalography. In all other instances scalp and does not apply to (a) distinctive physiologic
 37

events such as vertex sharp transients, lambda 12±14 Hz generally diffuse but of higher voltage
waves and positive occipital sharp transients of over the central regions of the head, occurring
sleep, (b) sharp transients poorly distinguished during sleep. Amplitude varies but is mostly
from background activity and sharp-appearing indi- below 50 pV in the adult. Synonym: sigma rhythm
vidual waves of EEG rhythms. (2) Sharp waves (use discouraged).
should be differentiated from spikes, i.e. transients Sleep stages: Distinctive phases of sleep best
having similar characteristics but shorter duration. demonstrated by polygraphic recordings of the
However, it should be kept in mind that this distinc- EEG and other variables, including at least eye
tion is largely arbitrary and primarily serves movements and activity of certain voluntary
descriptive purposes. As a rule, in ink-written muscles. Comment: classi®ed by various systems
EEG records taken at 3 cm/s, sharp waves occupy (Dement and Kleitman 1957; Rechtschaffen and
more than 2 mm of paper width and spikes 2 mm or Kales 1968).
less (see spike). Slow alpha variant rhythms: Characteristic
Sharp-and-slow-wave complex: A sequence of rhythms mostly at 4±5 Hz, recorded most promi-
a sharp wave and a slow wave. Comment: hyphena- nently over the posterior regions of the head.
tion facilitates use of term in plural form: sharp- Generally alternate, or are intermixed, with alpha
and-slow-wave complexes or sharp-and-slow- rhythm to which they often are harmonically
waves. related. Amplitude varies but is frequently close
Sigma rhythm: Use of term discouraged. Term to 50 mV. Blocked or attenuated by attention, espe-
suggested: sleep spindles. cially visual, and mental effort. Comment: slow
Silence, record of electrocerebral: Use of term alpha variant rhythms should be distinguished
discouraged. Term suggested: record of electrocer- from posterior slow waves characteristic of children
ebral inactivity. and adolescents and occasionally seen in young
Simultaneous: Occurring at the same time. adults.
Synonym: synchronous. Slow activity: Activity of frequency lower than
Sine wave: Wave having the form of a sine alpha, i.e. theta and delta activities.
curve. Slow spike: Use of term discouraged. Term
Single-ended ampli®er: An ampli®er that oper- suggested: sharp wave.
ates on signals that are asymmetric with respect to Slow spike-and-wave complex: Use of term
ground. discouraged. Term suggested: sharp-and-slow-
Sinusoidal: Term applies to EEG waves resem- wave complex.
bling sine waves. Slow wave: Wave with duration longer than
Six Hz spike-and-slow-wave: Spike-and-slow- alpha waves, i.e. over 1/8 s.
wave complexes at 4±7 Hz, but mostly at 6 Hz Small sharp spikes: Abbreviation: SSS.
occurring generally in brief bursts bilaterally and Synonym for benign epileptiform transients of
synchronously, symmetrically or asymmetrically, sleep (BETS) (preferred term).
and either con®ned to or of larger amplitude over Special electrode: Any electrode other than
the posterior or anterior regions of the head. Ampli- standard scalp electrode (see closely spaced elec-
tude varies but is generally smaller than that of trodes; ten±ten system).
spike-and-slow-wave complexes repeating at Sphenoidal electrode: Needle or wire electrode
slower rates. Comment: this pattern is of little clin- inserted through the soft tissues of the face below
ical signi®cance and should be distinguished from the zygomatic arch so that its tip lies near the base
epileptiform discharges. of the skull in the region of the foramen ovale.
Sleep onset REM (SOREM): Sleep onset REM Spike: A transient, clearly distinguished from
means the occurrence of REM less than 15 min background activity, with pointed peak at a conven-
after falling asleep. tional paper speed or time scale and a duration from
Sleep spindle: Burst at 11±15 Hz but mostly at 20 to under 70 ms, i.e. 1/50±1/15 s, approximately.
38

Main component is generally negative relative to gram: Abbreviation: SEEG. Intracerebral EEG
other areas. Amplitude varies. Comments: (1) recordings using electrodes implanted stereotacti-
term should be restricted to epileptiform cally, thus permitting the calculation of electrode
discharges. EEG spikes should be differentiated coordinates that can be projected on a stereotactic
from sharp waves, i.e. transients having similar brain atlas. The abbreviation SDEEG is also accep-
characteristics but longer durations. However, it table for stereotactic depth electroencephalogram.
should be kept in mind that this distinction is Stereotactic (stereotaxic) electroencephalo-
largely arbitrary and primarily serves descriptive graphy: Technique of recording stereotactic
purposes. Generally, in ink-written EEG records (stereotaxic) electroencephalograms. Abbreviation:
taken at 3 cm/s, spikes occupy 2 mm or less of SEEG.
paper width and sharp waves more than 2 mm. Sternospinal reference: A non-cephalic refer-
(2) EEG spikes should be clearly distinguished ence achieved by interconnecting two electrodes
from the brief unit spikes recorded from single placed over the right sterno-clavicular junction
cells with microelectrode techniques (see sharp and the spine of the seventh cervical vertebra,
wave). respectively, and balancing the voltage between
Spike-and-dome complex: Use of term discour- them by means of a potentiometer to reduce ECG
aged. Term suggested: spike-and-slow-wave artifact.
complex. Stickon electrode: Colloquialism. Use of term
Spike-and-slow-wave complex: A pattern discouraged. Term suggested: disk electrode.
consisting of a spike followed by a slow wave. Subclinical rhythmical discharges of adults
Comment: hyphenation facilitates use of term in (SREDA): This is a rhythmic pattern seen in the
plural form: spike-and-slow-wave complexes. adult age group which consists of a mixture of
Spike-and-slow-wave rhythm: Use of term frequencies, often predominant in the theta range.
discouraged. Terms suggested, whenever appro- It may resemble a seizure discharge but is not
priate: 3 per second spike -and-slow-wave accompanied by any clinical signs or symptoms.
complex, atypical spike-and-slow wave complex, The signi®cance of this pattern is uncertain, but it
sharp-and-slow-wave complex. should be distinguished from an epileptic seizure
Spindle: Group of rhythmic waves characterized pattern.
by a progressively increasing, then gradually Subdural electrode: Electrode inserted under
decreasing, amplitude (see sleep spindle). the dural covering of the cerebrum.
Spread: Propagation of EEG waves from one Suppression: EEG records showing activity
region of the scalp and/or brain to another (see below 10 mV (reference derivation) are termed
generalization). background suppression (see burst suppression
Standard electrode: Conventional scalp elec- pattern).
trode (see disk electrode, needle electrode, pad Symmetry: (1) Approximately equal amplitude,
electrode, special electrode). frequency and form of EEG activities over homo-
Standard electrode placement: Scalp electrode logous areas on opposite sides of the head. (2)
location(s) determined by the ten±twenty system Approximately equal distribution of potentials of
(see ten±twenty system). unlike polarity on either side of a zero isopotential
Status epilepticus, EEG: The occurrence of axis (see phase reversal). (3) Approximately equal
virtually continuous or repetitive seizure activity distribution of EEG waves about the baseline.
in an EEG. Term should be distinguished from clin- Synchrony: The simultaneous occurrence of
ical status epilepticus. EEG waves over regions on the same or opposite
Stephenson±Gibbs reference: Use of term sides of the head. Comment: term simultaneous
discouraged. Term suggested: sterno-spinal refer- only implies a lack of delay that is measurable
ence electrode. with ink writers at customary paper speeds or
Stereotactic (stereotaxic) electroencephalo- with standard computer display.
 39

Ten±ten system: System of standardized scalp to the input terminals of the ampli®er. Expressed in
electrode placement. According to this system, seconds (s). Abbreviation: TC. Comment: for a
additional scalp electrodes are placed at half simple RC coupling network, the TC is related to
distance between the standard electrodes of the the percent reduction in sensitivity of the channel at
ten±twenty system (see ten±twenty system, closely a given stated low frequency by the equation
spaced electrodes). Comment: use of additional, TC ˆ 1=2pf , where f is the frequency at which a
supplementary scalp electrodes is indicated for 30% (3 dB) attenuation occurs. For instance, for a
instance during epilepsy monitoring to better loca- TC of 0.3 s, an attenuation of 30% (3 dB) occurs at
lize epileptiform discharges. 0.5 Hz. Thus, either the time constant or the percent
Ten±twenty system: System of standardized attenuation at a given stated low frequency can be
scalp electrode placement recommended by the used to designate the same position of the low
International Federation of Societies for Electroen- frequency ®lter of the EEG channel (see low
cephalography and Clinical Neurophysiology. frequency ®lter).
According to this system, the placements of elec- Topography: Spatial distribution of EEG
trodes is determined by measuring the head from features (voltage ®elds, spectra, etc.) over the
external landmarks and taking 10 or 20% of these scalp or cerebral cortex.
measurements. Comment: the use of additional Trace alternant: A discontinuous pattern of
scalp electrodes, such as anterior temporal elec- non-REM (quiet) sleep seen in preterm infants of
trodes, is indicated in various circumstances 34 weeks conceptional age or older which can
(epilepsy monitoring). persist up to 3±4 weeks after birth in full term
Theta band: Frequency band from 4 to under 8 infants. The pattern is characterized by bursts of
Hz. Greek letter: u . predominantly slow waves (1±3 Hz, 50±100 mV)
Theta rhythm: Rhythm with a frequency of 4 to appearing approximately every 4±5 s, and inter-
under 8 Hz. vening periods of low voltage activity of ( , 50
Theta wave: Wave with duration of 1/4 to over mV) 4±7 Hz.
1/8 s. Trace continu: Continuous activity, replacing a
Three Hz spike-and-slow-wave complex: See 3 previously markedly intermittent record during
per second spike-and-slow-wave complex. evolution of EEG in preterm infants.
Three per second spike-and-slow-wave Trace discontinue: Pattern of preterm infants
complex: Characteristic paroxysm consisting of a below 34 weeks of conceptional age (CA) charac-
regular sequence of spike-and-slow-wave terized by mixed frequency high voltage bursts
complexes which: (1) repeat at 33.5 c/s (measured separated by periods of a very low voltage back-
during the ®rst few seconds of the paroxysm), (2) ground.
are bilateral in their onset and termination, general- Tracing: Synonyms: record, recording.
ized, and usually of maximal amplitude over the Transient, EEG: Any isolated wave or complex,
frontal areas, (3) are approximately synchronous distinguished from background activity.
and symmetrical on the two sides of the head Transverse bipolar montage: Synonym:
throughout the paroxysm. Amplitude varies but coronal bipolar montage.
can reach values of 1000 mV (1 mV) (see atypical Triangular bipolar montage: A montage
spike-and-slow-wave complex). consisting of derivations from pairs of electrodes
Time constant, EEG channel: The product of in a group of 3 electrodes arranged in a triangular
the values of the resistance (in mega-ohms, MV ) pattern. Use of this montage is discouraged,
and the capacitance (in microfarads, mF) which because false lateralization may occur.
make up the time constant control of an EEG Triphasic wave: High-amplitude (over 70 mV)
channel. This product represents the time required positive sharp transients, which are preceded and
for the trace to fall to 37% of the de¯ection initially followed by relatively low-amplitude negative
produced when a DC voltage difference is applied waves. The ®rst negative wave generally has a
40

lower amplitude than the negative afterwave. The May arise in the brain (EEG wave) or outside it
distribution is generalized, and frequently the (extracerebral potential).
largest de¯ections in a bipolar fronto-occipital deri- Wave form (waveform): The shape of an EEG
vation occur at the frontal electrodes. Triphasic wave.
waves tend to have a repetition rate of ca. 1±2 Hz. White lead: Use of term discouraged. Term
suggested: input terminal 2.
Unilateral: Con®ned to one side of the head. Wicket rhythm: Use of term discouraged. Term
Comments: (1) unilateral EEG activities may be suggested: mu rhythm.
regional or lateralized to one hemisphere. (2) Wicket spikes: Spike-like monophasic negative
They are said to be lateralized to the right or left single waves or trains of waves occurring over the
side of the head. temporal regions during drowsiness that have an
Unipolar: Use of term discouraged. Term arcuate or mu-like appearance. These are mainly
suggested: referential. seen in older individuals and represent a benign
Unipolar derivation: Use of term discouraged variant that is of little clinical signi®cance.
(see referential derivation). Writer. System for direct write-out of the output
Unipolar depth electrode: Use of term discour- of an EEG channel. Most writers use ink delivered
aged. Term suggested: single-electrode lead. by a pen. In certain instruments, the ink is sprayed
Unipolar montage: Use of term discouraged. as in a jet stream. In other recorders the pen writer
Term suggested: referential montage. uses carbon paper instead of ink. Laser printers are
also used in digital EEG.
Vertex sharp transient: Sharp potential,
maximal at the vertex, negative relative to other Zero potential reference electrode: Use of term
areas, apparently occurring spontaneously during discouraged. Term suggested: reference electrode
sleep or in response to a sensory stimulus during (not a synonym).
sleep or wakefulness. May be single or repetitive.
Amplitude varies but rarely exceeds 250 mV.
Abbreviation: V wave (see K complex).
Vertex sharp wave: Use of term discouraged References
when describing physiologic vertex sharp transient.
Brazier, M.A.B., Cobb, W.A., Fischgold, H., Gastaut, H., Gloor, P.,
Voltage: Derived by multiplying trace amplitude Hess, R., Jasper, H., Loeb, C., Magnus, O., Pampiglione, G.,
times display or pen output sensitivity (see ampli- ReÂmond, A., Storm van Leeuwen, W., Grey, W. Preliminary
tude). proposal for an EEG terminology by the terminology committee
of the International Federation for Electroencephalography and
Volume conduction: Through the process of Clinical Neurophysiology. Electroenceph. clin. Neurophysiol.,
volume conduction, electrical activity originates 1961, 13: 646±650.
from a generator and spreads through a conductive Chatrian, G.E., Bergamini, L., Dondey, M., Klass, D.W., Lennox-
Buchthal, M., PeterseÂn, I. A glossary of terms most commonly
medium to be picked up by a distant recording
used by clinical electroencephalographers. Electroenceph. clin.
electrode. Volume conduction is passive and is Neurophysiol., 1974, 37: 538±548.
picked up synchronously at all recording electrodes Dement, W. and Kleitman, N. The relation of eye movements
at the speed of light. during sleep to dream activity: an objective method for the
study of dreaming. J. Exp. Psychol., 1957, 53: 339±346.
V wave: Abbreviation for vertex sharp transient. Rechtschaffen, A. and Kales, A. A Manual of Standardized Termi-
nology, Techniques and Scoring System for Sleep Stages of
Wave: Any change of the potential difference Human Subjects. Brain Information Service/Brain Research
Institute, Los Angeles, CA, 1968.
between pairs of electrodes in EEG recording.