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Table Of Contents

Section 3 EEG/PSG Measurement

Operator's Manual WEE-1000 3C.1

Section 3 EEG/PSG

Measurement

General ................................................................................................................................ 3.1

EEG Waveform Acquisition .......................................................................................3.4

About Polysomnography ............................................................................................ 3.4

Flowchart of Waveform Measurement .......................................................................3.5

Attaching the Electrodes (EEG Measurement) .................................................................... 3.6

Guidelines for Input Jack Use ...................................................................................3.6

Required Electrodes ........................................................................................3.6

Input Jack Z ....................................................................................................3.6

Input Jacks C3 and C4....................................................................................3.6

Input Jacks A1 and A2.................................................................................... 3.6

Checking Original Electrode Potentials for All Active Electrodes .................... 3.6

Introduction to Electrode Position, Derivation and Montage ......................................3.7

Electrode Position ...........................................................................................3.7

Derivation ........................................................................................................ 3.7

Monopolar Derivations (Referential Derivation) ................................................3.7

Bipolar Derivation ............................................................................................3.8

Montage (Pattern) ............................................................................................ 3.8

Attaching the Electrodes to the Patient .....................................................................3.9

EEG Scalp Disk Electrodes .......................................................................... 3.10

Electrode Positions ....................................................................................... 3.10

Earlobe Electrodes ........................................................................................ 3.11

Attaching the Electrodes and Sensors (PSG Measurement) ............................................. 3.12

Measurement Parameters and Attachment Sites .................................................... 3.12

Electroencephalogram (EEG) ........................................................................ 3.12

Electrooculogram (EOG) ............................................................................... 3.12

Electromyogram (EMG) ................................................................................ 3.12

Electrocardiogram (ECG) .............................................................................. 3.12

Attaching the Electrode ................................................................................. 3.13

Respiration (Airflow, Chest, Abdomen) .......................................................... 3.15

Snore ............................................................................................................ 3.16

Body Position ................................................................................................ 3.16

Periodic Limb Movements (PLM) .................................................................. 3.16

Oxygen Saturation (SpO

) ............................................................................. 3.17

Connecting the Electrodes and Sensors to the Electrode Junction Box ............................ 3.19

Summary of content (27 pages)

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Section 3 EEG/PSG Measurement General ................................................................................................................................ 3.1 EEG Waveform Acquisition ....................................................................................... 3.4 About Polysomnography ............................................................................................ 3.4 Flowchart of Waveform Measurement .......................................................................
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3. EEG/PSG MEASUREMENT General Operation WARNING When using the NE-224S Sub-dermal Straight Needle Electrode • Do not use the NE-224S sub-dermal straight needle electrode as a measurement electrode for the EEG or evoked potential measurement for any longer than one hour. When measuring the EEG or evoked potential for over one hour, use the EEG disk electrode. • Do not check the skin-electrode impedance when using a needle electrode or intracranial electrode.
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. EEG/PSG MEASUREMENT CAUTION • Do not use a device which uses Bluetooth® wireless technology and wireless LAN device which complies with IEEE 802.11b near the wireless input unit at the same time. If they are used together, the radio waves interfere with each other. This may prevent the communication between the telemetry unit and access point by reducing transmission speed and transmission distance. • Do not give impact to the telemetry unit. Spike noise may be superimposed on the waveform.
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3. EEG/PSG MEASUREMENT Electrode Attachment/Cable Connection WARNING • Do not connect the Z electrode lead plug on the electrode junction box to a ground or equipotential ground. Otherwise, leakage current from another instrument cause electrical shock to the patient. • Only connect a BF type instrument to the DC connector on the telemetry unit. Otherwise, leakage current from the other instrument causes electrical shock to the patient.
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3. EEG/PSG MEASUREMENT EEG Waveform Acquisition The Acquisition program acquires the EEG/PSG waveforms and can display up to 64 channels of EEG/PSG waveforms. You can save the acquired waveforms with the patient information, annotations, amplifier settings and display settings in a hard disk or MO disk as an EEG data file. For the operation of the Acquisition program, refer to the operator’s manual of the electroencephalograph.
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3. EEG/PSG MEASUREMENT Flowchart of Waveform Measurement 1. Attach the EEG electrodes and sensors to the patient. 2. Connect the electrode junction box and cables to the telemetry unit. 3. Attach the telemetry unit to the patient. 4. Turn on the telemetry unit and access point. 5. Start the Acquisition program (New file automatically opens). 6. Select the telemetry unit and access point. 7. Enter the patient information. 8. Check skin-electrode contact impedance. 9. Lock the telemetry unit. 10.
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3. EEG/PSG MEASUREMENT Attaching the Electrodes (EEG Measurement) Guidelines for Input Jack Use You must follow these guidelines to obtain correct EEG recordings. Required Electrodes Do not perform EEG measurement without the Z, C3, C4, A1 and A2 electrodes. Input Jack Z Connect the lead from the electrode (Z electrode) attached on the patient’s nasion to input jack Z on the electrode junction box. This input jack is used to eliminate AC interference.
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3. EEG/PSG MEASUREMENT Introduction to Electrode Position, Derivation and Montage Electrode Position There are various systems of electrode position, such as Illinois, Montreal, Aird, Cohn, etc. Of these, the International 10-20 system, shown below, is currently the most common. Each system has a different number of electrodes and different electrode locations. To compensate for different sized heads, the distances between electrodes are given as ratios.
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3. EEG/PSG MEASUREMENT Monopolar Derivations Using Other Site Reference Electrodes: • Vx (Vertex reference derivation) Mid-line central position Cz as the reference electrode. • AV (Average reference derivation) The potential of all electrodes on the scalp, except for the extra electrodes, are averaged point and used for the AV reference electrode.
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3. EEG/PSG MEASUREMENT Attaching the Electrodes to the Patient WARNING • Do not connect the Z electrode lead plug on the electrode junction box to a ground or equipotential ground. Otherwise, leakage current from another instrument cause electrical shock to the patient. • Only connect a BF type instrument to the DC connector on the telemetry unit. Otherwise, leakage current from the other instrument causes electrical shock to the patient.
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3. EEG/PSG MEASUREMENT EEG Scalp Disk Electrodes 1. Clean the area where the electrodes are to be mounted with a gauze pad moistened in alcohol or a medical soap solution to remove oil from the skin. Wipe the site with dry gauze. Wrong Correct 2. Apply a small amount of EEG paste to a 1 cm diameter circle on the cleaned skin. Avoid spreading the paste too thin or creating too large a space. 3.
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3. EEG/PSG MEASUREMENT 5. Take the line passing over F7, Fz and F8 and attach an electrode at the midpoint (F3) between F7 and Fz as shown in Fig. 4. Attach another electrode at the mid-point (F4) between F8 and Fz. Fig. 4 FP1 FP2 1 2 F7 13 F8 F3 15 4 19 3 C3 T3 F4 FZ C4 CZ 24 5 14 T4 16 6 12 11 A1 A2 T5 17 P3 P4 20 7 8 PZ O1 O2 9 10 T6 18 6. Take the line passing over T5, Pz and T6 and attach an electrode at the midpoint (P3) between T5 and PZ.
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3. EEG/PSG MEASUREMENT Attaching the Electrodes and Sensors (PSG Measurement) Measurement Parameters and Attachment Sites C4 C3 EEG A2 A1 E2 E1 EOG A1 A2 EOG This section explains the standard attachment sites of the electrodes and sensors for measuring polysomnogram. Electroencephalogram (EEG) The EEG waveforms are measured with the monopolar derivations from C3-A2 (or C4-A1) and O1-A2 (or O2-A1).
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3. EEG/PSG MEASUREMENT Attaching the Electrode You must follow these guidelines to obtain correct EEG recordings. Required Electrodes Do not perform EEG measurement without the Z, C3, C4, A1 and A2 electrodes. Input Jack Z Connect the lead from the electrode (Z electrode) attached on the patient’s nasion to input jack Z on the electrode junction box. This input jack is used to eliminate AC interference. The input jack Z is also used for checking electrode impedance.
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3. EEG/PSG MEASUREMENT Procedure This section explains how to attach the disk electrodes. When using collodion disk electrodes, refer to its operator’s manual. Correct Disk electrode Wrong 1. Clean the skin where the electrodes are attached with a cotton swab moistened with alcohol or SkinPure (skin preparation gel) to remove oil from the skin. Wipe the skin with a dry cotton swab. When attaching the electrodes for the EEG measurement, make sure that the skin-electrode contact impedance is 5 kΩ or less.
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3. EEG/PSG MEASUREMENT For attaching procedure and cautions/note, refer to the operator’s manual of each sensor. CAUTION Before attaching a sensor, check whether it contains dry natural rubber or not. Natural rubber may cause allergic reaction with symptoms such as itching, redness, urticaria, swelling, fever, dyspnea, symptoms similar to asthma, reduced blood pressure and shock.
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3. EEG/PSG MEASUREMENT Snore The snore is measured from the neck by the airway vibration. The Pro-Tech Dynamic Snoring Microphone is recommended for the measurement. • Take care to attach the sensor because the carotid artery pulse waveforms are measured as artifact if the sensor is attached around the carotid artery.
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3. EEG/PSG MEASUREMENT Oxygen Saturation (SpO2) The oxygen saturation is measured from the finger or earlobe with the SpO2 probe manufactured by Ninon Medical Inc. through the JL-101A SpO2 Adapter. WARNING • Measurement may be incorrect in the following cases.
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3. EEG/PSG MEASUREMENT Caution - continued • Use the disposable probe only once and for one patient only. Do not reuse the disposable probe for another patient. It will cause cross infection. • When the attachment site is wet with blood or when the patient has nail polish on, remove the dirt and nail polish before attaching the probe. The transmitted light may decrease due to the blood or nail polish and the measurement data may be incorrect.
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3. EEG/PSG MEASUREMENT Connecting the Electrodes and Sensors to the Electrode Junction Box Connect the electrodes and sensors to the electrode junction box. Two types of electrode junction box can be used. • JE-011A Electrode Junction Box 30 channels of EEG waveforms or 22 channels of EEG waveforms, 8 channels of bipolar signals and 2 channels of DC input signals.
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3.
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3. EEG/PSG MEASUREMENT Attaching the Telemetry Unit to the Patient When attaching the telemetry unit to the patient use the provided, pouch, belt and strap. Electrode junction box Event marker Strap Belt Telemetry unit SpO2 probe Pouch Operator's Manual WEE-1000 Isolator 3.
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3. EEG/PSG MEASUREMENT Changing the Measurement Settings Before starting measurement, check and change the following system settings in the System Program. The changed settings are saved in memory. The Acquisition program and the Review program use these settings.
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3. EEG/PSG MEASUREMENT Measuring Waveforms This section explains the general procedure how to measure the waveforms. 1. Start the communication between the telemetry unit and access point. Wireless communication: 1) Turn on the access point 2) Press the START/OK key on the telemetry unit. Blinking “O” is displayed on the LCD display. Wired communication: 1) Turn on the access point 2) Connect the telemetry unit and access point with the isolator. The channel “CL” is displayed on the LCD display. 2.
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3. EEG/PSG MEASUREMENT Pattern dialog box 5. Select the pattern. You can select the pattern (montage and amplifier settings including sensitivity, high-cut filter, time constant, etc.) for the measurement with the Pattern dialog box. You can program the pattern for the measurement in the System Program. For the detailed pattern settings, refer to "Programming Pattern” in Section 4 of the operator’s manual of the electroencephalograph. 6. Check the skin-electrode contact impedance for disk electrodes.
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3. EEG/PSG MEASUREMENT On the screen: 1) Move the mouse pointer to the Impedance Check button on the tool bar. 2) Press and hold the left mouse button for about two seconds to start the skin-electrode impedance check. The Impedance Check dialog box opens on the screen. The currently selected montage is displayed on the dialog box. The impedance check result is displayed on the screen with measured impedance and color.
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3. EEG/PSG MEASUREMENT 8. Start filing. Click the Start/Stop Filing button on the tool bar to start saving the acquired waveforms in an EEG data file. 9. Save the file and end the measurement. 1) Click the Start/Stop Filing button to stop saving. 2) From the File menu, select Close. The Close dialog box opens to let you check the patient information. 3) Click the OK button to close the data file. 4) From the File menu, select Exit to close the Acquisition program.