What is an EEG examination for children? What is an encephalogram of the brain and why is it done for children? About the main rhythms of electrical activity of the brain

For convenience, both doctors and patients replace the long word “electroencephalography” with an abbreviation and simply call this diagnostic method EEG. It should be noted here that some (probably to enhance the significance of the study) talk about EEG of the brain, but this is not entirely correct, since the Latinized version of the ancient Greek word “encephalon” is translated into Russian as “brain” and in itself is already part medical term– encephalography.

Electroencephalography or EEG is a method of studying the brain (BM) in order to identify foci of increased convulsive readiness of its cortex, which is typical for (the main task), tumors, conditions after a stroke, structural and metabolic, sleep disorders and other diseases. Encephalography is based on recording the electrical activity of the brain (frequency, amplitude), and this is done with the help of electrodes attached in different places on the surface of the head.

What kind of research is an EEG?

Periodically occurring convulsive seizures, occurring in most cases with complete loss of consciousness, are popularly called epilepsy, which official medicine calls it epilepsy.

The very first and main method for diagnosing this disease, which has served humanity for many decades (the first EEG recorded dates back to 1928), is encephalography (electroencephalography). Of course, the research apparatus (encephalograph) has now significantly changed and improved, its capabilities with the use of computer technology have expanded significantly. However, the essence of the diagnostic method remains the same.

Electrodes (sensors) are connected to the electroencephalograph, which are placed in the form of a cap on the surface of the subject’s head. These sensors are designed to capture the slightest electromagnetic bursts and transmit information about them to the main equipment (device, computer) for automatic processing and analysis. The encephalograph processes the received impulses, amplifies them and records them on paper in the form of a broken line, very reminiscent of an ECG.

Bioelectric activity of the brain is created mainly in the cortex with the participation of:

• The thalamus, which oversees and redistributes information;
• The ARS (activating reticular system), the nuclei of which, located in various parts of the brain (medulla oblongata and midbrain, pons, diencephalic system), receive signals from many pathways and transmit them to all parts of the cortex.

The electrodes read these signals and deliver them to the device, where recording occurs (graphic image - encephalogram). Information processing and analysis - tasks software a computer that “knows” norms of biological activity of the brain and the formation of biorhythms, depending on age and a specific situation.

For example, routine EEG detects the formation of pathological rhythms during an attack or in the period between attacks; sleep EEG or nighttime EEG monitoring shows how the biopotentials of the brain change while immersed in the world of dreams.

Thus, electroencephalography shows the bioelectrical activity of the brain and the consistency of the activity of brain structures during wakefulness or during sleep and answers the questions:

1. Are there any foci of increased convulsive readiness of the brain, and if they are, in what area are they located?
2. What stage is the disease at, how far has it progressed or, conversely, has it begun to regress;
3. What effect does the chosen medicine have and is its dose calculated correctly;

Of course, even the most “smart” machine will not replace a specialist (usually a neurologist or neurophysiologist), who receives the right to decipher an encephalogram after undergoing special training.

Features of EEG in children

What can we say about kids, if some adults, having received a referral for an EEG, begin to ask what and how, because they doubt the safety of this procedure. Meanwhile, it actually cannot cause any harm to the child, but it can be really difficult to perform an EEG on a small patient. For babies under one year old, the bioelectrical activity of the brain is measured during sleep, before this they wash their hair, feed the baby and, without deviating from the usual schedule (sleep/wake), adjust the procedure to the child’s sleep.

But if for children under one year old it is enough to wait until they fall asleep, then a child from one to three years old (and some even older) still needs to be persuaded, therefore, up to 3 years of age, the study is carried out in a state of wakefulness only for calm and sociable children, giving preference in other cases to EEG sleep.

Preparations for visiting the appropriate office should begin several days in advance, turning the future trip into a game. You can try to interest the baby in a pleasant trip, where he can go with his mother and his favorite toy, come up with some other options (usually parents are more aware of how to convince the child to sit quietly, not move, cry or talk). Unfortunately, such restrictions are very difficult for young children to withstand, because they still cannot understand the seriousness of such an event. Well, in such cases the doctor is looking for an alternative...

Indications for performing daytime encephalography in a child in a state of sleep or nighttime EEG are:

• Detection of paroxysmal conditions of various origins – epileptic seizures, convulsive syndrome against the background of high body temperature (febrile convulsions), epileptiform seizures not associated with true epilepsy and differentiated from it;
• Monitoring the effectiveness of antiepileptic therapy with an established diagnosis of epilepsy;
• Diagnosis of hypoxic and ischemic lesions of the central nervous system (presence and severity);
• Determination of the severity of brain lesions for prognostic purposes;
• Study of the bioelectrical activity of the brain in young patients to study the stages of its maturation and the functional state of the central nervous system.

In addition, it is often suggested to do an EEG with frequent and delayed acquisition of speech skills and stuttering. This method should not be neglected in other cases that require studying the reserves of the functional capabilities of the brain, because the procedure is both harmless and painless, but can provide maximum information for diagnosing a certain pathology. Electroencephalography is very useful if episodes of disturbances of consciousness occur, but their cause is not clear.

Different recording methods

Registration of bioelectric potentials of the brain is carried out different ways, For example:

1. At the beginning of a diagnostic search that identifies the causes of paroxysmal conditions, a short-term (≈ 15 min) routine method of recording an encephalogram, which, to identify hidden disorders, involves the use of provocative tests - the patient is asked to breathe deeply (hyperventilation), open and close his eyes, or is given light stimulation (photostimulation);
2. If a routine EEG does not provide the necessary information, the doctor prescribes deprivation encephalography(sleep deprivation at night, completely or partially). To conduct such a study and obtain reliable results, a person is either not allowed to sleep at all, or is woken up 2-3 hours before the subject’s “biological alarm clock” rings;
3. Long-term EEG recording recording the bioelectrical activity of the brain cortex during “quiet hours” (EEG sleep) occurs if the doctor suspects that changes in the brain occur precisely while in “sleep mode”;
4. Experts consider the most informative night EEG, which is recorded in a hospital setting. The study begins while you are awake (before going to bed), continues when you fall asleep, covers the entire period of night sleep and ends after natural awakening. If necessary, registration of bioelectrical activity of the brain is supplemented by the application of supernumerary electrodes and the use of video recording equipment.

Long-term recording of electrical activity over several hours during sleep and recording of nighttime EEG is called EEG monitoring. Naturally, such methods require the use of additional equipment and material resources, as well as the patient’s stay in a hospital setting.

Time and equipment make up the price

In other cases, there is a need to measure the biopotentials of the brain at the time of an attack. Pursuing similar goals, the patient, as for conducting an overnight EEG, is sent to a hospital for hospitalization, where 24-hour EEG monitoring is carried out using audio and video equipment. Continuous EEG monitoring with video recording throughout the day makes it possible to verify the epileptic origin of paroxysmal memory disorders, isolated auras, as well as episodic psychomotor phenomena.

Electroencephalography is one of the most available methods brain research. And for the price too. In Moscow, you can find this study for 1,500 rubles, and for 8,000 rubles (EEG sleep monitoring for 6 hours), and for 12,000 rubles (night EEG).

In other cities of Russia you can get by with a smaller amount, for example, in Bryansk the price starts from 1200 rubles, in Krasnoyarsk - from 1100 rubles, and in Astrakhan it starts from 800 rubles.

Certainly, It's better to do an EEG specialized clinic neurological profile, where in doubtful cases there is the possibility of a collegial diagnosis (in such institutions many specialists can encrypt the EEG), as well as obtain a doctor’s consultation immediately after the test or quickly resolve the issue regarding other methods of brain research.

About the main rhythms of electrical activity of the brain

When interpreting the results of the study, various factors are taken into account: the age of the subject, his general condition (the presence of tremor, weakness in the limbs, visual impairment, etc.), anticonvulsant therapy at the time of recording the bioelectric activity of the brain, the approximate time (date) of the last seizure and etc.

The electroencephalogram consists of various complex biorhythms emanating from the electrical activity of the brain in different periods time depending on specific situations.

When decoding the EEG, first of all, pay attention to the main rhythms and their characteristics:

• Alpha rhythm(frequency - in the range from 9 to 13 Hz, oscillation amplitude - from 5 to 100 μV), which is present in almost all people who have no complaints about their health during inactive wakefulness (relaxation during rest, relaxation, shallow meditation) . As soon as a person opens his eyes and tries to visually imagine any picture, α-waves decrease and may disappear altogether if the functional activity of the brain continues to increase. When deciphering the EEG, the following parameters of the α-rhythm are important: amplitude (μV) over the left and right hemispheres, dominant frequency (Hz), dominance of certain leads (frontal, parietal, occipital, etc.), interhemispheric asymmetry (%). α-rhythm depression is caused by anxiety states, fear, activation of autonomic nervous activity;
• Beta rhythm(frequency ranges from 13 to 39 Hz, oscillation amplitude is up to 20 μV) - this is not only our wakefulness mode, the β-rhythm is characteristic of active mental work. IN in good condition the expression of β-waves is very weak, their excess indicates an immediate reaction of the brain to stress;
• Theta rhythm(frequency – from 4 to 8 Hz, amplitude ranges from 20-100 µV). These waves do not reflect pathological change consciousness, for example, a person is dozing, half-asleep, in the stage of superficial sleep, he is already seeing some dreams, and then θ-rhythms are detected. U healthy person falling into sleep is accompanied by the appearance significant amountθ rhythms. An increase in the theta rhythm is observed during prolonged psycho-emotional stress, mental disorders, twilight states characteristic of some neurological diseases, asthenic syndrome, concussion;
• Delta rhythm(frequency ranges from 0.3 to 4 Hz, amplitude - from 20 to 200 μV) - characteristic of deep immersion in sleep (natural falling asleep and artificially created sleep - anesthesia). With various neurological pathologies, an increase in the δ wave is observed;

In addition, other electrical oscillations occur in the cerebral cortex: gamma rhythms reaching high frequencies (up to 100 Hz), kappa rhythms formed in the temporal leads during active mental activity, mu rhythms associated with mental stress. These waves are not particularly interesting from a diagnostic point of view, since they arise under significant mental stress and intense “work of thought”, requiring high concentration of attention. An electroencephalogram, as is known, is recorded, although during wakefulness, but in a calm state, and in some cases, overnight EEG or sleep EEG monitoring is even prescribed.

Video: alpha and beta rhythms on EEG

EEG interpretation

main EEG leads and their designations

A bad or good EEG can only be judged after the final interpretation of the study results. Thus, We will talk about a good EEG if, during the waking period, the following were recorded on the encephalogram tape:

• In the occipital-parietal leads - sinusoidal α-waves with an oscillation frequency ranging from 8 to 12 Hz and an amplitude of 50 μV;
• In the frontal areas - β-rhythms with an oscillation frequency greater than 12 Hz and an amplitude not exceeding 20 μV. In some cases, β-waves alternate with θ-rhythms with a frequency of 4 to 7 Hz and this is also considered normal.

It should be noted that individual waves are not specific to any particular pathology. An example is epileptiform sharp waves, which under some circumstances can appear in healthy people who do not suffer from epilepsy. Conversely, peak-wave complexes (frequency 3 Hz) clearly indicate epilepsy with petit mal seizures, and sharp waves (frequency 1 Hz) indicate a progressive degenerative disease of the brain - Creutzfeldt-Jakob disease, therefore these waves with decoding is considered an important diagnostic feature.

In the period between attacks, epilepsy may not be noticed, since the peaks and sharp waves characteristic of this disease are not observed in all patients who show all clinical symptoms pathology at the time of a convulsive attack. Moreover, paroxysmal manifestations in other cases can be recorded in absolutely healthy people who do not have any signs or prerequisites for the development of a convulsive syndrome.

In connection with the above, having conducted a single study and not finding epileptic activity on the background EEG (“good EEG”), it is impossible to completely exclude epilepsy based on the results of one test if clinical signs of the disease occur. It is necessary to further examine the patient for this unpleasant disease using other methods.

Recording an EEG during a seizure in a patient with epilepsy may provide the following options:

1. Frequent electrical discharges of high amplitude, which indicate that the peak of the attack has occurred, slowing down of activity - the attack has entered the attenuation phase;
2. Focal epiactivity (it indicates the location of the focus of convulsive readiness and the presence of partial seizures - you will have to look for the cause of the focal lesion of the brain);
3. Manifestations of diffuse changes (registration of paroxysmal discharges and peak-wave) - such indicators indicate that the attack is generalized.

As for other diseases in which pathological electrical activity has nothing to do with epilepsy, they can be recorded in the form of focal brain lesions and diffuse changes. For example, a slow rhythm with a predominance of θ- and δ-waves is considered a generally valid identifier twilight consciousness of various origins (,), which in the case of focal brain damage manifests itself more noticeably on the side of the GM suffering than on the healthy side.

If the origin of the brain lesion is established, and diffuse changes are recorded on the EEG, then the diagnostic value of this study, although not so significant, still makes it possible to find one or another disease that is far from epilepsy:

• Meningitis (especially caused by herpetic infection) - on the EEG: periodic formation of epileptiform discharges;
• Metabolic encephalopathy - on the encephalogram: the presence of “triphasic” waves or diffuse slowdowns in rhythm and bursts of symmetrical slow activity in the frontal areas.

Diffuse changes in the encephalogram can be recorded in patients who have suffered a brain injury or concussion, which is understandable - with severe head injuries, the entire brain suffers. However, there is another option: diffuse changes are found in people who do not have any complaints and consider themselves absolutely healthy. It happens and if not clinical manifestations pathology, then there is no reason to worry either. Perhaps, at the next examination, the EEG recording will reflect complete normality.

In what cases does EEG help make a diagnosis?

Electroencephalography, revealing the functionality and reserves of the central nervous system, has become the standard for brain research; doctors consider its implementation advisable in many cases and for various conditions:

1. To assess the degree of functional immaturity of the brain in young patients (in a child under one year old, the study is always carried out during sleep, in older children - depending on the situation);
2. For various sleep disorders (frequent awakenings at night, etc.);
3. In the presence of epileptic seizures;
4. To confirm or exclude complications of inflammatory processes caused by neuroinfection;
5. At, );
6. Patients in a coma need to have their brain assessed;
7. In some cases, research is required surgical operations(determining the depth of anesthesia);
8. Encephalography will help to recognize how far neuropsychic disorders have gone in hepatic cellular failure (hepatic encephalopathy), as well as in other forms of metabolic encephalopathies (renal, hypoxic);
9. To all drivers (future and current) when passing medical examination To obtain/replace a license, they offer to undergo an EEG for a certificate provided by the traffic police. The examination is easy to use and easily identifies those who are completely unfit to drive vehicles, which is why it was adopted;
10. Electroencephalography is prescribed to conscripts who have a history of convulsive syndrome (based on medical card data) or in case of complaints of attacks with loss of consciousness accompanied by convulsions;
11. In some cases, a study such as EEG is used to ascertain the death of a significant part nerve cells, that is, brain death (we're talking about about situations when they say that “a person most likely turned into a plant”).

Video: EEG and detection of epilepsy

The study does not require special preparation

An EEG does not require any special preparation, but some patients are openly afraid of the upcoming procedure. It’s no joke - sensors with wires are placed on the head, which read “everything that is happening inside the skull” and transmit the full amount of information to the “smart” device (in fact, the electrodes record changes in the potential difference between two sensors in different leads). Adults are provided with symmetrical attachment to the surface of the head of 20 sensors + 1 unpaired one, which is superimposed on the parietal region; for a small child, 12 is enough.

Meanwhile, I would like to reassure particularly suspicious patients: the study is absolutely harmless, has no restrictions on frequency and age (at least several times a day and at any age - from the first days of life to old age, if circumstances so require).

The main preparation is to ensure the cleanliness of the hair, for which the day before the patient washes his hair with shampoo, rinses and dries well, but does not use any chemical hair styling products (gel, foam, varnish). Metal objects used for decoration (clips, earrings, hairpins, piercings) are also removed before an EEG is performed. Besides:

• For 2 days, they give up alcohol (strong and weak), do not drink drinks that stimulate the nervous system, and do not indulge in chocolate;
• Before the study, obtain medical advice regarding medications taken (sleeping pills, tranquilizers, anticonvulsants, etc.). It is possible that certain medications will have to be discontinued in consultation with the treating doctor, and if this cannot be done, then you should inform the doctor who will be involved in deciphering the encephalogram (a note on the referral form) so that he keeps these circumstances in mind and takes them into account when drawing up the conclusion.
• 2 hours before the examination, patients should not allow themselves a heavy meal and relaxation with a cigarette (such activities can distort the results);
• It is not recommended to do an EEG in the midst of an acute respiratory illness, as well as during coughing and nasal congestion, even if these signs do not relate to the acute process.

When all the rules preparatory stage are observed, certain points are taken into account, the patient is seated in a comfortable chair, the places of contact between the surface of the head and the electrodes are lubricated with gel, sensors are attached, a cap is put on or dispensed with, the device is turned on - the recording begins... Provocative tests are used as necessary during the recording of the bioelectric activity of the brain brain As a rule, this need arises when routine methods do not provide adequate information, that is, when epilepsy is suspected. Techniques that provoke epileptic activity ( deep breathing, opening and closing the eyes, sleep, light irritation, sleep deprivation), activate the electrical activity of the GM cortex, the electrodes capture the impulses sent by the cortex and transmit them to the main equipment for processing and recording.

In addition, if epilepsy is suspected (especially temporal epilepsy, which in most cases presents difficulties in diagnosis), special sensors are used: temporal, sphenoidal, nasopharyngeal. And, it should be noted, doctors have officially admitted that in many cases it is the nasopharyngeal abduction that detects the focus of epileptic activity in the temporal region, while other leads do not react to it in any way and send normal impulses.

Video: specialists about EEG - information for patients

Video: conducting an EEG - medical film

Electroencephalography (EEG) records the potentials of electrical activity and reveals changes that occur in the child’s head. Such an examination for the child’s body will harmlessly and accurately show all the changes that occur in various pathologies. EEG of the brain in children is performed without special problems, if the parents prepare the child for the procedure in advance.

EEG must be done when:

• Regular loss of consciousness;
• , seizures of cerebral origin;
• Inflammatory diseases;
• Headache;
• Chronic neurological diseases;
• All kinds of formations of the central nervous system;
• In preparation for brain surgery;
• Congenital pathology of the central nervous system;
• Delayed psychoneurological development.

What is diagnosed on an EEG

After deciphering the EEG, the following is diagnosed:

• Inflammatory disease of the meninges. Characterized by febrile temperature, malaise, profuse headache,.
• Epilepsy, in which a child has recurrent, stereotypical seizures.
• A common congenital disease in children. Characterized by the accumulation of excessive amounts of spinal fluid in the ventricles of the brain. Causes: often these are birth injuries, inflammatory diseases in children.
• Volumetric formations of the brain. The etiology is not completely clear. Assume hereditary factor, ionizing radiation, lifestyle, in particular parents, etc.
• Hemorrhages. The most common causes are injuries and diseases of the hematopoietic system. The child complains of dizziness, headaches, and lethargy.
• Cerebral palsy (cerebral palsy) is a pathology of the brain due to its underdevelopment or injury during pregnancy and childbirth. Factors influencing the development of this pathology: trauma, infectious and endocrine diseases of the mother.

Is it possible for children to have an EEG?

EEG has no absolute contraindications and can be performed on all children without exception, even infants. If the child is capricious or restless, then before the study they are given sedatives, and they also conduct an examination at the places where special sensors are attached. Availability open wounds, abrasions, maceration gives the doctor the right to postpone the procedure.

How to prepare for the procedure

Before starting, the doctor must give correct recommendations parents:

• The child should not be hungry and should not eat or drink for 2 hours. Products containing caffeine, chocolate, etc., which have a stimulating effect on the central nervous system, are strictly prohibited.
• For babies, the brain scan is done while the baby is sleeping.
• For children over one year of age, an electroencephalogram is performed during activity. But there are also nuances here: the child must be psychologically prepared and fulfill all the doctor’s requirements.
• To make your baby feel comfortable, you can take his favorite things and present them all to him as a game.
• All items that may interfere with the examination (hairpins, earrings, chains...) must be removed, hair must be clean and loose
• If your child is taking any medications, be sure to notify the doctor about this.

Carrying out an EEG

Electroencephalography stages:

1. Recording data at rest.
2. Tests with opening and closing the eyes (they can be carried out with the child in several game form). Eye opening is responsible for inhibition processes, and closing is responsible for excitation in the cerebral cortex.
3. Forced breathing. Take a deep breath and exhale. You can offer the child to play with the dog. This test can help in detecting formations and epilepsy.
4. The final stage is photostimulation. The doctor turns on the lamp, which begins to blink and go out at certain intervals. This helps us identify areas of epileptic activity and assess the child’s psychophysical development.

The study will take no more than 25 minutes. The doctor can carry out another series diagnostic tests, for example: squeezing and unclenching the hand, sound stimulation, etc.

Electroencephalogram recording

The examination proceeds as follows: special sensors are fixed on the child’s head. They look like a helmet, which is made of various materials (fabric, rubber). Before this, the scalp is lubricated with a special liquid, gel, for better conductivity and the examination begins. Babies remain in the arms of their parents or on a changing table; older children are given a semi-sitting position.

Decoding the results

An electroencephalogram is a strip of paper on which a continuous line is recorded, with waves and teeth, a certain frequency, amplitude, rhythm,

The result with a conclusion is delivered to you the next day. There are a large number of electroencephalography indicators, as a result of which the specialist’s experience and professional skills are important. So, for example, in 7% of children suffering, obvious changes may not be detected, but based on indirect signs, a competent doctor will always suspect a deviation from the norm.

EEG indicators:

• Alpha rhythm. Abnormalities indicate a tumor or cyst, hemorrhages, which indicate organic pathology. In case of TBI, a high frequency appears; in neurotic conditions, a weakness of the rhythm is detected.
• Beta rhythm. Deviations from the norm indicate traumatic brain injury, concussion.
• Theta rhythm and delta rhythm. We determine the brain activity of babies during sleep. Its registration on the EEG while awake indicates problems in the area where this rhythm is recorded. The appearance of paroxysms indicates mental underdevelopment. The presence of these abnormalities, such as adhesions or a sharp wave, indicates epileptiform changes in the brain.
• Electrical activity. Characterized by its rhythm. If this indicator is violated, epilepsy or convulsive syndrome can be suspected.
• M-Echo. An indicator that evaluates the degree of displacement of brain structures. Normally no more than one millimeter.

The final diagnosis will be made by an experienced neurologist, based on complaints, clinical manifestations, and additional research methods, which include electroencephalography.

Most parents are scared if their child is scheduled for an electroencephalography procedure. In fact, this examination is safe and extremely informative.

It is carried out for children of different ages, prescribed by a pediatrician, psychiatrist or neurologist according to the indications available for this or as an examination to eliminate suspicions of the presence of disorders.

A doctor can prescribe the procedure for a child from birth to age 18.

A referral is issued in the following cases:

• Complaints of headaches in the mornings and/or evenings.
• Epileptic seizures.
• , occurring unexpectedly, at any time, even at rest.
• Disturbances in normal sleep.
• Walking in your sleep.
• The child complains of nightmares and frequently recurring nightmares.
• Frequent loss of consciousness.
• Unstable.
• Behavioral disorders: increased aggression, irritability, short temper.
• Hyperactivity, increased excitability or inhibition.
• Violations mental development.
• Speech delay or disturbance.
• Slow development of the child.
• Continuous crying.
• Hydrocephalus.
• Birth injuries, including cerebral palsy.
• Autism.
• Consequences of brain surgery.
• The presence or suspicion of a tumor of various origins.
• Inflammatory processes in the brain and its membranes (encephalitis, arachnoiditis).
• Pathologies of cerebral circulation.
• Concussion and its consequences.
• Any injuries to the skull, including after a fall with a blow to the head.
• The child’s complaints about unpleasant and incomprehensible sensations that he cannot thoroughly accurately describe.

The doctor will explain to parents what the EEG of the brain shows in children and will reassure them by telling them that the procedure helps identify the cause of the disease or disorder, and can also exclude the presence of the disease. This allows you to quickly and with minimal trauma to the child obtain very important data on the state of his health, make an accurate diagnosis and quickly begin appropriate treatment.

How to prepare a child for an examination?

A few days before the examination, you need to stop taking anticonvulsant and sedative medications.

An electroencephalogram allows you to get exact information about the presence of a disease or exclude it, identify the stage of the process and the location of the disorder. Also, with the help of this examination, it is possible to record objective data on the impact of the treatment, its effectiveness and the speed of elimination of the negative process.

In physical terms, preparation for an EEG is minimal. It consists only of thoroughly washing your hair, because for this purpose special sensors will be put on it. Sebum and dirty hair can interfere with normal contact, so your head should be as clean as possible.

It is much more difficult to psychologically prepare a child for the procedure. If he is old enough, the parents will have to explain in detail the essence of the procedure and its purpose. Children should be completely calm and relaxed during the examination, so the role of parents is to convey to them information about the complete harmlessness and painlessness of the future examination.

Newborns and infants under 12 months of age undergo the procedure exclusively while they sleep.

This is due to the fact that a awake baby will cry, scream and be capricious, which will not allow obtaining objective data about the state and functioning of his brain. Therefore, parents agree to conduct an EEG at a time when the baby is usually used to sleeping. During the examination, the baby is placed on a changing table or remains in the mother's arms. He should be well-fed and not too tired to avoid overexcitation and moodiness.

Children older than one year do not sleep during the procedure. With kids of this age group it is most difficult to achieve relaxation and calmness, so it would be best if the parents tell the child that this is such a special game and promise him something interesting for good behavior. It is important not to be nervous yourself, because the anxiety of parents, especially mothers, is quickly transmitted to the baby and has a bad effect on his behavior.

More information about EEG can be found in the video:

By reducing everything to a fun game, it will be much easier to explain to your child the need to wear special sensors on his head. To make your baby feel comfortable, you should take his favorite toy with you.

Before the examination, the child needs to be fed, so he will be calmer. But extreme fatigue should be avoided, as this can lead to moodiness. It is necessary to prepare the child in advance for the doctor’s requests to open and close his eyes on command; for this you can come up with a game and rehearse the process in advance.

Before the examination, all medications except anticonvulsants are discontinued. A sick child should not undergo an EEG; it is better to reschedule the procedure for another time.

How is the EEG procedure performed?

In order to perform an EEG, a network of interconnected sensors is placed on the child’s head. They are connected by a thin mesh of wires or attached to a special cap.

To obtain full contact, the sensors are lubricated with a special gel or saline solution. If the skin where the sensors are attached is too oily, the physician can wipe it with alcohol.In addition to the “cap” with sensors, the child will have special clips placed on his ears. They do not conduct current.

Putting on sensors can frighten an unprepared child, so this point needs to be discussed and explained to the baby in advance. If the child is still small, you can boil it all down to the fact that the cap is a space helmet that will make him a superhero, or find any other acceptable explanation. The main thing is that the child is calm, not nervous and feels comfortable. This is very important to obtain accurate and truthful information.

The further procedure depends on the age of the child. The baby sleeps during the test, and older children are examined according to the following scheme:

• Taking readings in a relaxed reclining position.
• Record with eyes open and closed.
• Hyperventilation. The child must, at the doctor’s command, deeply inhale and exhale air, make movements simulating blowing out a candle, and so on. Such a test can reveal hidden tumors or manifestations of epilepsy.
• Photostimulation. The child's eyes are closed, but the blinking light is noticeable to him and causes a response from the brain. This test is used to assess the child's development.

The standard duration of the examination is half an hour. If additional tests are necessary, its duration may be slightly increased.

Parents should not be afraid of performing the procedure; it is completely safe, does not expose the child’s brain to any radiation, but only records data on its electrical activity. Contraindications and side effects There are no diagnostics for this type.

Pathologies and disorders detected using EEG

The encephalogram can distinguish 4 main rhythms - alpha, beta, theta and delta

The result of the examination is an encephalogram. It looks like a long ribbon with a series of teeth of varying sizes. Only an experienced specialist can read and interpret the data correctly.

What does an EEG of the brain show in children:

• Abnormalities in the amplitude and frequency of the alpha rhythm in a specific area of ​​the brain may indicate the presence of injury, hemorrhage, or a neoplasm. Detection of deviations in the alpha rhythm necessarily indicates the presence of a developmental delay in the child.
• In a normal state, the beta rhythm is formed only in frontal lobes. Its shift to other areas of the brain indicates a delay mental development baby. If the amplitude and/or frequency of the beta rhythm changes, this is an indication of the presence of a concussion or an inflammatory process in the brain.
• Delta and theta rhythms are recorded during a child's sleep. Scattered indicators may indicate the presence of psychoses, neuroses or dementia. The appearance of a sharp wave or flash is an indicator of the presence of epilepsy.

An EEG is an informative examination, but a diagnosis is not made solely on the basis of its data. The doctor collects full information about the health status of a small patient, evaluates it, and only on the basis of comprehensive data makes an accurate diagnosis.

The procedure can not only confirm suspicions and make a diagnosis, but also refute them, so people are afraid of it and under no circumstances should they refuse the examination.

Quite often, any neurological abnormalities in the baby’s health are associated with the state of the brain. Modern medicine allows not only to practically look inside this organ, but also to record its work in different periods. For parents, as a rule, all studies related to the child’s brain cause concern, but most of them are completely safe and do not cause any pain or harm to the baby. Such a study is EEG. Children can do it almost from birth. Let's figure out what it is when it is prescribed.

The essence of encephalography

EEG is one of the methods for studying brain activity. The method is based on recording the electrical potentials of a given organ. During the study, the result is obtained in the form of visual curves - an encephalogram.

The structural unit of the brain is neurons. There are billions of them, they are capable of generating and conducting electrical impulses. Activity large quantity nerve cells simultaneously forms the bioelectrical activity of the brain, which is recorded by the device.

An EEG is done on a child to determine the activity of brain cells. It, in turn, will show how effectively and correctly the main organ of the central nervous system exercises control over important systems and organs. A competent specialist who evaluates the results of an encephalogram is able to determine the child’s nervous system. If there are deviations, then treatment is necessary.

Indications for encephalography

When, after another visit to the doctor, a neurologist prescribes an EEG of the child’s brain, the parents immediately begin to think that something is wrong with their baby. But every mother should understand that such a study is not necessarily prescribed for babies with neurological disorders. They can send you for an EEG and quite healthy child to assess brain function. Even a therapist can prescribe the procedure, but neurologists most often prescribe it for the following conditions, and this is done in mandatory:

1. Frequent convulsions and fits.
2. If the child has suffered a head injury.
3. If there is a tumor in the brain.
4. The baby suffers from frequent headaches and may experience loss of consciousness.
5. For sleep disorders, including sleepwalking.
6. The child is often quick-tempered and irritable.
7. The child often cries for no reason.
8. There are surges in blood pressure.
9. An EEG is prescribed to a child if he describes strange sensations and experiences unusual emotions.

But even in the absence serious pathologies and there may be abnormalities in the baby’s behavior and development; in such cases, the doctor most often also prescribes encephalography. It will help identify the causes of developmental delays, hyperactivity or bad memory and attention.

A neuropathologist must prescribe EEG monitoring for children (a procedure with a certain frequency) if the following conditions and pathologies are present:

• Epilepsy, to assess the degree of damage to brain structures.
• Sleepwalking and other sleep disorders.
• Rehabilitation period after surgical intervention in the brain area.
• In the presence of inflammatory diseases of the brain, for example meningitis, meningoencephalitis.
• Pathologies of the perinatal period, for example hydrocephalus in newborns.
• Presence of cerebral palsy.
• Autism is also an indication for an EEG.
• Delayed mental and physical development.
• Enuresis and stuttering.

As can be seen from the above, EEG is prescribed to children for many problems that are directly or indirectly related to the functioning of the nervous system.

Goals of EEG diagnostics

This test helps the doctor evaluate:

1. The nature of brain disorders and the degree of their severity.
2. Location of the damaged area of ​​the brain.
3. Change of periods of sleep and wakefulness.
4. Treatment effectiveness.

Depending on what the child's EEG shows, the doctor may decide that other procedures and tests are necessary. For example, a CT scan may be needed.

How to prepare a child for an EEG procedure

Before going for the encephalography procedure, the child should be prepared. To do this, you must follow some rules and recommendations:

1. Since sensors will be installed on the baby’s head, it is necessary to wash the hair before the procedure.
2. If the procedure is performed on a very small child, say, an infant, then before doing this it is necessary to feed him so that he is calm.
3. Since EEG is performed on infants while they are sleeping, it is necessary to take into account their sleep and wake schedule in advance.
4. If the child is over a year old, then encephalography is done while he is awake, so it is important that the baby is calm and follows all the doctor’s instructions.
5. To make your child behave more confidently, you can take his favorite toy with him.
6. If the procedure is performed on a girl, then all hairpins and jewelry must be removed from the head and the hair should be loosened.
7. If therapy is carried out with medications, then you should not stop it before the procedure, you just need to tell the specialist about it.
8. With young children at home, you can practice putting on a hat by incorporating it into everyday games.

The psychological preparation of the child is also important, so psychologists recommend:

• Talk to the baby and describe the future procedure as an exciting game.
• You can take your favorite book with you to the clinic to distract your baby from the process by reading.
• Be sure to correlate the child’s usual daily routine with the procedure. Feed the baby, and the older child should remain awake.
• You can rehearse some of the doctor’s commands at home: opening and closing your eyes, breathing at different rates.

If parents take the preliminary preparation of the baby for such a procedure responsibly, then everything will go quickly and smoothly.

EEG options

The bioactivity of the brain can be recorded in different ways, so doctors distinguish several options for conducting encephalography:

1. The routine way. The biopotentials of the brain are recorded for 15 minutes, and provocations in the form of flashes are carried out at the same time. bright light or deep breathing.
2. The long-term option involves fixing the work of the brain, taking into account daytime sleep.
3. Long-term measurements during the entire night's sleep.
4. The last option is a measurement with sleep deprivation (such an EEG is done extremely rarely for children, only if necessary).

The doctor will decide which encephalography option to choose in each specific case.

Start of the procedure

If a neurologist prescribes this test for children, the specialist will explain in detail after receiving the results. The procedure is carried out in a special room into which no extraneous sounds penetrate. There is also a device installed here that will record brain impulses in the form of a curve.

Before the procedure begins, a cap is placed on the baby’s head; it looks like a helmet with electrodes; the specialist attaches the required number of sensors to it, which are connected to an encephalograph. The biocurrents that are conducted through the electrodes are completely harmless to the child.

All equipment must be grounded, and before applying the sensors, the doctor wets them with water or saline solution to prevent the formation of an air cushion between the head and the electrode. Special electrode clips are placed on the baby's ears; they do not conduct electric current.

What are the features of the EEG procedure?

Taking into account the child’s age, the procedure for conducting encephalography is selected. If the baby is very small, then he can lie in his mother’s arms or on the changing table. The most important thing is that he sleeps. The entire procedure will take no more than 20 minutes, because brain activity is recorded during the sleep period.

Older children sit on a couch or in a chair; their head should be straight, it should not be tilted forward so that its readings are distorted. A small patient should behave calmly during the examination. EEG is done a little differently for older children. The procedure involves more complex studies and may therefore take much longer.

Stages of encephalography

If we consider the standard EEG procedure, it consists of the following stages:

1. Recording brain activity at rest - obtaining a “background curve”.
2. Recording brain activity during the transition from a state of rest to activity. This is a test with opening and closing the eyes. The child must follow the doctor's commands.
3. Hyperventilation test. It allows you to detect epilepsy in hidden form, various brain tumors, prolonged stress. At the specialist’s command, the child takes deep breaths and exhales. With your baby, you can turn such measurements into a game by asking him to “blow on the hot tea” or “put out the candle.”
4. Photostimulation helps to assess the adequacy of the baby’s psychomotor and speech development, and it is also possible to diagnose epileptic activity. Using a light bulb, periodic flashes of light are made, while the eyes should be closed.

The procedure usually takes about 30 minutes, if necessary additional research, then the time increases.

Evaluation of results

There are EEG standards for children that a neurologist must know, so after the study, parents are given a drawing or curve and a description. The following points should be reflected:

1. Rhythm (alpha, beta, theta and delta), its location and frequency.
2. Presumable nature of the pathology.
3. Preliminary diagnosis.

With this conclusion and drawing, the little patient and his mother are sent to a neurologist, who will give all the explanations.

What does the alpha rhythm mean?

If a specialist notes a disturbance in the alpha rhythm, this may indicate the presence of a tumor in the brain, injury or hemorrhage. In a child, this may indicate developmental delay, especially if there is:

• Excessive amplitude and synchronicity.
• Displacement of the center of activity from the parietal and occipital zones.
• Violent activity during deep breathing.

Beta rhythm

If you do an EEG on a completely healthy child, then this rhythm is recorded only in the frontal lobes. If there is a shift to the central parts of the brain, this may indicate a delay in mental development.

If a change in frequency or amplitude is diagnosed, this may indicate a concussion or inflammatory processes in the tissues.

Assessment of theta and delta rhythm

These two rhythms can be detected in a healthy baby only during sleep. Their presence in the encephalogram may indicate the child’s dementia, a tendency toward psychosis or neurosis.

Flashes and sharp waves are most often recorded during epileptiform activity and confirm the diagnosis of epilepsy. Only EEG can be used to confirm this diagnosis.

All other indicators that are reflected in the description of the curve can only be analyzed and commented on by a competent specialist. And only after an accurate diagnosis can the necessary treatment be prescribed.

Where to do an EEG for a child

This procedure can be done in a medical institution that has the appropriate equipment and specialists to carry it out. Despite the fact that the process of examining children and adults is practically no different, the doctor is required to have additional knowledge in the field of pediatric encephalography.

As for the capital of Russia, an EEG for a child in Moscow can be done at the Neuro-Med medical center. IN medical institution everything is available necessary equipment, and the most modern, there are specialists in conducting children's EEG. Experienced doctors have enough knowledge to decipher the results, and will also quickly find a common language with the baby.

Do not be afraid of modern research, including encephalography. It is better to detect deviations in a timely manner and take appropriate measures than long time to treat the suspected disease to no avail.

Electroencephalography (EEG) is one of the accurate ways to study the functioning of the central nervous system. It is performed to detect brain impulses and evaluate them. This is necessary for accurately diagnosing a small patient and prescribing proper treatment. Parents are usually scared of any interventions prescribed for their child, however, the method is completely painless and not dangerous.

What is EEG?

The essence of conducting an EEG for a child is to study the impulses sent by the cerebral cortex. The nervous system contains a huge number of neurons (nerve cells) that constantly broadcast nerve impulses V different departments body. It is from the totality of these impulses that the general activity brain. During the EEG, it is detected and recorded graphically, that is, an encephalogram is obtained. This is a printout with a large number of curved lines, which the doctor deciphers and makes a conclusion about the course of all processes in the brain - healthy or pathological.

EEG of the brain in children is prescribed at any age. An EEG is done to identify foci of convulsive readiness and their locations, determine the stage of the disease, and also to determine the effectiveness of the treatment. After an EEG, it is important how accurately its result is deciphered - the patient’s diagnosis depends on this.

EEG in children

Carrying out an electroencephalogram in children has some peculiarities. It is difficult to administer to a small child under 1 year old. In this regard, the procedure is carried out while the baby is sleeping.

It is a little more difficult to conduct research for a child under 3 years old - he already understands a lot and needs to be persuaded and explained what they want from him. If the child willingly agrees, then the procedure is carried out while he is awake, otherwise you will also have to wait until he falls asleep.

Carrying out an EEG in children over 5 years of age, as a rule, does not cause difficulties; just talk to him.

Important. Start the explanatory process not in the doctor’s office, but at home, in a familiar environment, so that the child is ready and not afraid of an unfamiliar environment.

Indications for EEG for children

An electroencephalogram is performed for children only for its intended purpose. pediatric neurologist. This usually happens when:

• repeated repeated fainting;
• convulsive states and various seizures of an unknown nature;
• TBI and its consequences;
• neoplasms and other brain diseases;
• assessing the level of development of a child in the first year of life;
• attacks of dizziness and frequently recurring pain in the head;
• sleep disorders, especially signs of sleepwalking;
• changes in psycho-emotional state – increased irritability and hot temper;
• frequent crying of the child for no apparent reason;
• changes in blood pressure;
• lack of natural reaction of the baby to external stimuli(fading);
• inexplicable sensations in an older child;
• rehabilitation and postoperative periods after neurosurgical interventions;
• pathological conditions and pathologies of the fetus and newborn that arise during the perinatal period;
• inflammation of the brain, carried out for diagnostic purposes;
• autism or cerebral palsy;
• delayed physical or mental development of unknown cause;
• epilepsy to analyze brain damage and prescribe (or withdraw) treatment;
• vegetative-vascular dystonia;
• delay in establishing speech in a child, stuttering.

The list of diseases and disorders for which EEG is indicated is quite impressive; each disturbing symptom requires detailed consideration and adequate treatment. Therefore, if your doctor orders a test, do it right away. After all, the sooner correct diagnosis will be established, the more successful the correction will be. An EEG will help answer the following questions:

• whether there are foci of pathology in the child’s brain and, if so, where they are located;
• determine the stage of the existing disease, the severity of its course, and confirm the correctness of the chosen method of treatment.

Important. This type of study, such as EEG, has no age restrictions and is prescribed to newborn infants and adolescents.

Preparing a child for an EEG

For the examination, specific equipment will be placed on the child’s head. Therefore, it is important to explain to an older child why this is required and that it is not scary at all.

1. When performing the procedure on an infant, coordinate the choice of time for the study with his sleep schedule - the EEG will be performed during this period. Be sure to feed your baby before the session.
2. For older children, imagine the procedure as an exciting adventure. This will allow you to safely attach the device to his head. Practice doing something similar at home so that your baby doesn’t get scared.
3. To ensure peace of mind, take your favorite toys or books and use them to distract your baby if necessary.
4. In some cases, the child will be required to do what the doctor says - open and close his eyes, undergo various tests, and breathe in a special way. Parents should warn their child against such situations.
5. If the child is taking any prescribed medications, be sure to use them as directed before the examination. standard scheme. However, the doctor who performs the EEG must know this in advance. The only exception is anti-seizure medications; they are discontinued three days before the EEG.
6. The study is postponed if the baby has a cold. At the wrong moment, he begins to sneeze and cough, which will negatively affect the result.
7. By the time the procedure begins, all foreign objects (earrings, hair clips) must be removed from the child and the hair must be loosened.
8. By the time the procedure begins, the scalp and hair should be washed and dried, without a hint of any cosmetic substances.
9. Before the procedure, the child should be calm, well-fed and well-rested.
10. The manipulation is carried out in a soundproofed room, where there is a couch for the patient and EEG equipment.
11. Immediately before the examination, an EEG device is placed on the child’s head. This is either a special cap with electrodes connected to it, or a rubber mesh on which the doctor will attach the sensors.
12. Where these sensors contact the surface of the head, the skin is lubricated with gel.
13. Special clips that are not electrically conductive are placed on the child’s ears.
14. If the study is carried out on a baby, it remains in the mother’s arms or is placed on a changing table. The child should be asleep by now.
15. The baby’s calm behavior during the procedure is an important point. It will play a special role in the interpretation of the results.
16. The duration of the session is about 20 minutes.
17. Older children do not lie down during the procedure, but are in a semi-sitting position. In this case, it is important to keep your head still - you cannot move it or tilt it forward.

How is an EEG performed?

EEG stages:

• recording brain activity at rest;
• test with closed and with open eyes to determine brain activity during the transition from rest to activity. All that is required of the child is to open and close his eyes at a specific time;
• test with hyperventilation - these are various respiratory movements. Such a test is important - it allows you to identify neoplasms or a latent form of epilepsy;
• a test with photostimulation will help identify disturbances in the child’s psychomotor and speech activity. It can also be used to detect signs of epilepsy. The essence of the test is to periodically turn on and off a light bulb near the child with his eyes closed. In particular, the baby’s reaction to a stimulus with his eyes closed is assessed here.

This procedure will not take more than 30 minutes. If additional research is required, then it will take longer. These include: influences sound signals, squeezing - unclenching of the child's hands, certain psychological tests, photostimulation with dark adaptation, recording values ​​throughout the entire period of night sleep.

EEG options

1. Routine EEG - takes only 10-15 minutes and during its process only biological activity brain with two provocations - light and deep breathing.
2. A long-term EEG is performed with a sleep study in daytime or recording the results of a night's sleep.
3. With night sleep deprivation - a rare method used in exceptional cases. The period of sleep deprivation varies - this is decided by the doctor. The essence of the method is that the child is deliberately kept from falling asleep for some time, and then his brain activity is examined and recorded. This EEG method is used to clarify the diagnosis and monitor treatment.

Which EEG method will be used should also be decided by the attending physician.

Purposes of EEG

Such an effective and accurate method as EEG allows a neurologist to assess the following conditions:

• changes in periods of wakefulness and sleep of the child and their frequency;
• violations and pathological processes, occurring in the brain and their nature;
• location of the inflammatory focus;
• the effectiveness of the treatment (especially for epilepsy).

Important. Based on the results of the study, the doctor will be able to give recommendations on the advisability of prescribing further examinations, for example, computed tomography and others.

Decoding the results

The results of the procedure are usually ready the next day. They appear as a printout with many curved lines or a similar document on a computer. The doctor examines all these lines, the spaces between them and makes a description with a conclusion attached to the EEG. The description necessarily contains the activity and dynamics of the waves, a decoding of the results and their correspondence to previously detected symptoms.

If there is even the slightest doubt about the reliability and accuracy of the results, the procedure is prescribed again. To do the EEG again, be sure to have all previous results with you. They are compared with new ones. Small child is developing rapidly, in particular its nervous system, therefore, EEG results at different periods of life have different indicators.

Types of rhythm according to EEG results:

1. Alpha rhythm - observed at rest over both cerebral hemispheres. If there is a disturbance in amplitude, frequency and amplification in any one hemisphere, then this indicates the presence of a neoplasm and indicates injury or hemorrhage. Increased amplitude, excessive activity in the crown and back of the head, increased reaction during deep inhalations indicate a delay in the child’s psycho-emotional state.
2. The beta rhythm is normally present only in the frontal lobes. If a similar rhythm is detected in any other areas, it indicates a delay in mental development.
3. Theta and delta rhythms normally differ only when the child is sleeping. In all other cases, these rhythms indicate dementia, psychosis or neurosis in the child.
4. A flash (spike) is a confirmation of the presence of epilepsy (the diagnosis can only be reliably confirmed using an EEG).

Patient assessment

When the doctor begins to describe the electroencephalogram, he takes into account all the points and gives a conclusion. Negative indicators based on EEG results include:

• barrier symmetries in any hemisphere over 30%;
• manifestation of a wave with sinus rhythm;
• the presence of an arc-shaped rhythm;
• general rhythm increased by 50%;
• a beta wave with a sick amplitude indicates a traumatic brain injury;
• an amplitude of less than 50 volts means the child has a concussion.

Contraindications

EEG is a method that differs favorably from some others precisely in the absence of absolute contraindications. In children with mental disorders An anesthesiologist performs medicinal sanitation. Moreover, the drug is used for this purpose only after a laboratory examination.

Only a neurophysiologist should carry out the procedure and interpret the results. Even neurosurgeons and neurologists require detailed transcript EEG. An incorrectly read EEG leads to an inaccurate diagnosis and the prescription of incorrect treatment. This will not only be ineffective, but even unsafe for the life of a small patient.

Conclusion

With such an accurate and effective examination, it is possible to detect serious illnesses. This is especially important for a small patient - the sooner treatment is started, the better the result. Parents must follow the doctor's instructions and undergo all recommended examinations. It is important to understand the severity of the disease and the consequences if an accurate and timely diagnosis is not carried out.