What is the procedure for using EEG to determine the electrical activity in the brain?

A seizure is an electrical disturbance that occurs suddenly and uncontrollably in the brain. It can cause changes in behavior, movements or feelings, and level of consciousness. Seizures that are not caused by fever occur in 1 out of every 250 children. If they recur, the child is said to have epilepsy.

During a convulsion, a child may lose consciousness and fall over, eyes may roll back, the body stiffens, and arms and legs may jerk. Most seizures last less than 5 minutes.

Seizure

A seizure is a condition of spontaneous disruption of electrical activity in the brain, either partially or in all areas of the brain. Seizures can be characterized by uncontrollable body movements, eye movements, blank stares, and can be accompanied by a decrease in consciousness. The duration of the seizure can also be short in seconds or minutes, or it can be prolonged and repeated. If a seizure occurs, it should be treated immediately and the cause of the seizure investigated.

Seizures in children

Children can experience seizures. Seizures in children can be caused by several diseases such as febrile seizures, epilepsy, meningitis, encephalitis, head injury or trauma, congenital abnormalities of the brain, or brain tumors.

Epilepsy.

The number of epilepsy cases in children and young adults is relatively high, especially in developing countries such as Indonesia. Epilepsy is caused by impaired nerve function in the brain that causes a condition of "hyperexcitability", which is a condition where the nerves lack inhibitory factors so that the nerves constantly receive impulses / stimuli that appear as manifestations of seizures.

Epilepsy can be caused by structural brain abnormalities, genetics, infections, metabolic disorders, autoimmune diseases, or even unknown causes. Many risk factors for epilepsy are associated with the process of fetal development in pregnancy as well as problems during labor and after birth, some of which include a history of severe illness in pregnancy, brain injury, febrile seizures, family history of epilepsy, low apgar scores at birth, stress, electrolyte disturbances, acute toxic effects, sepsis, central nervous system infections, or autoimmunity.

Recurrent febrile seizures in children are one of the risk factors for epilepsy in children. As many as 3% of children with febrile seizures will develop epilepsy in the future. The risk of epilepsy in complex febrile seizures is 5-10 times higher than in simple febrile seizures. Therefore, it is important for parents to immediately bring their children to the doctor when seizures appear to get appropriate treatment and management.

Symptoms of epilepsy can present in several forms of seizures such as jerky body movements in part or all of the body, glaring eyes, blank stare in one direction, rapid eye blinking, or muscle stiffness. Seizures may also be accompanied by loss of consciousness, foaming at the mouth, temporary cessation of breathing, or absent-mindedness. The duration of the seizure can also be in seconds or minutes and there can be more than one seizure episode. To find out whether the patient has epilepsy or not, it is necessary to see a doctor to go through several diagnostic stages ranging from anamnesis, physical examination, to supporting examinations.

Until now, EEG is still one of the supporting examinations and is the gold standard for diagnosing epilepsy.

EEG

Electroencephalography or EEG is a test that records electrical activity in the brain. Usually doctors recommend this examination to help diagnose diseases in the brain, one of which is epilepsy. EEG is able to detect electrical waves produced by brain activity, which then appear as graphs on a computer screen or in the form of recordings that can be printed on paper. Brain cells are always active even when a person is sleeping, in addition to brain cells communicating through electrical impulses.

Procedure

Before the EEG, the nurse and doctor will usually inform various medical matters, such as allergies, medications consumed, and so on. This includes what preparations need to be done before the EEG:

1. Washing hair the night before the day of the examination, preferably not using conditioner
2. Do not use hair spray or gel on the day of the examination
3. Not taking psychotropic medications, such as chlorpromazine and haloperidol,
4. Do not consume caffeine within 24 hours before the EEG.
5. Patients should sleep less than usual the night before the examination.
6. The patient should not fast before the examination to avoid low blood sugar levels so as not to affect the results of the EEG test.

The procedure during EEG is:
    1. The recommended patient position is a relaxed and comfortable position, such as lying down or sitting leaning on the available place. Patients must feel relaxed to avoid interference, including contractions of the scalp muscles and neck muscles can cause artifacts in the examination results.
    2. Installation of EEG equipment in the form of electrodes in the form of 20-25 electrodes that have been connected to the machine on the scalp or hat mounted on the patient's head.
    3. In children, drugs can be given to give the effect of sedation to the child, so that during the examination the patient can fall asleep and cooperate. 
    4. The examination will last approximately 20 to 40 minutes.
    5. When the examination begins, the patient is asked to relax and close his/her eyes. At certain times, the technician will ask the patient to take a deep breath, watch the lights blink, open and close their eyes, and so on. The aim is to see the brain's response when the body performs activities.
    6. When finished, the technician will remove the electrodes attached to the patient's scalp.
    7. The results of the EEG examination will later be examined by the doctor to follow up on the patient's condition.
Electroencephalogram Side Effects
There are almost no complications caused by this examination, because EEG is a non-invasive supporting examination that is relatively safe for patients. However, electrodes attached to the scalp can sometimes cause mild irritation, such as itching or a red rash appearing in the area.
     Electroencephalogram may trigger seizures in patients with epilepsy. This can happen due to flashing lights during the EEG procedure. And this can be done with the aim of evaluating brain conditions in patients with epilepsy complaints. Therefore, patients should inform their doctor about their body condition thoroughly before going for an electroencephalogram procedure.