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Michalis Koutroumanidis

, Dimitrios Sakellariou

, and Vasiliki Tsirka

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date: 16 May 2022

This chapter concentrates on essential technical aspects of the electroencephalogram (EEG) and its role in the clinical and aetiological diagnosis of people with epilepsy. The technical subsection explores important stages of the largely ‘mystifying’ process from the generation of the abnormal signals in the brain to their final visualization on the screen, including digitalization of the signal and sampling rate, montages, and derivations, focusing on their clinical relevance. The second part reviews the behavioural attributes of the interictal and ictal discharges in the different epilepsy types and syndromes, discusses the optimal use of activation methods, including sleep deprivation and sleep, hyperventilation, photic, and other specific stimulation, and describes specific diagnostic tools like polygraphy and cognitive assessment during apparently subclinical discharges. It also discusses aspects of the clinical EEG interpretation and reporting and delineates indications and limitations of the EEG.

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