Internal Medicine

Atlas of sleep medicine by Sudhansu Chokroverty, Robert Thomas, Meeta Bhatt

By Sudhansu Chokroverty, Robert Thomas, Meeta Bhatt

This accomplished atlas of tracings of polysomnographic stories covers the technical facets of engaging in experiences, and comprises the good points of some of the grownup and pediatric sleep issues.

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If the artifact persists, then electrodes need to be changed. Other sources of artifacts are the electrode wires, the cables, and the switches. In the PSG machine, random fluctuations of charges result in some instrumental noise artifacts. If the sensitivity is greater than 2 microvolts per millimeter, which is not generally used in PSG recordings, then these instrument artifacts may interfere with the recording. Loose contacts in switches or wires may also cause sudden changes in voltage or loss of signal.

Electroencephalography for the Sleep Specialists 35 FIGURE 2–4. A: EEG shows transient burst of delta activity in the left temporal, and occasionally also in the right temporal, region in a 94-year-old woman with history of syncope. 36 Electroencephalography for the Sleep Specialists FIGURE 2–4, cont’d B: Same subject data as in A viewed at a 30-second epoch. ABNORMAL EEG PATTERNS The abnormal pattern may consist of focal or diffuse slow waves and epileptiform discharges. The importance of multiple channel EEG recordings is to document those focal (Figure 2–5) or diffuse (Figure 2–6) slow waves and epileptiform discharges.

Electrode paste or conducting gel is used to secure the electrodes. Positive and negative chargers are generated between the scalp and recording electrode as a result of ionic dissociation. The electrodeelectrolyte interface is the most critical link in the PSG machine, as most of the artifacts originate at this site and careful preparation is therefore very important. The impedance in a pair of electrodes should be measured by an impedance meter and should not be greater than 5000 (5K) ohms. High impedance impairs the ability of the electrical signal to reach the amplifier and interferes with the capacity of the amplifier to eliminate environmental noise, thus increasing the artifacts.

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