NDT 232 - EEG Procedures and Pathology IV

1. Identify normal awake and sleep patterns in children 3 months to 18 years of age.
2. Identify abnormal awake and sleep patterns in children 3 months to 18 years of age. 
3. Discuss neurological disorders commonly found in neonates and pediatric patients.
4. Describe the physiological variables among neonates and pediatric patients.
5. Discuss protocols for performing EEG’s in the critical care department.

A. Objectives

1. Explain the elements of age-appropriate pediatric care.

2. Identify the ages/stages of development and suggested best practices for technologists:

a. Infant: Birth to 1 year “Trust vs. Mistrust”

b. Toddler: 1-3 years “Autonomy vs. Shame and Doubt”

c. Pre-school: 4-7 years “Initiative vs. Guilt”

d. School age: 8-12 years “Industry vs. Inferiority”

e. Adolescence: 13 to 18 years “Identity vs. Role Confusion”

3. Describe measures that add to patient comfort and gain cooperation during the EEG procedure.

4. Explain ways to incorporate behavior techniques that add to patient comfort and gain cooperation during the EEG procedure.

B. Assignments

1. Complete Links:

a. ACNS Guideline 5

b. ASET Presentation: Pediatric Age Appropriate Care

c. ASET Slides Lesson 1

d. Poster: Pediatric EEG w/o Sedation

e. ASET Article: Pediatric Sedation vs Music Therapy

f. ASET Position Statement

g. Technical Tips

2. Complete Quiz 1

3. Complete Assignment 1

II. Module 2

A. Objectives

1. Describe normal awake patterns in children 3 months to 18 years.

2. Explain passive eye closure and its usefulness to view background activity.

3. Recognize Posterior Slow Waves of Youth.

4. Chart the development of normal awake posterior dominant rhythms.

5. Describe activation procedures such as sleep, photic stimulation, and hyperventilation.

6. Identify Photic driving in infants.

7. Recognize HV Buildup in children.

8. Identify normal variants commonly seen in children such as: Lambda & Mu Rhythm.

B. Assignments

1. Complete Links:

a. Reading Material Lesson 2

b. ASET Article: What is Normal?

c. ASET Article: EEG Maturation

d. Part 1 Neonatal EEG

e. Part 2 Infant, Pediatric, and Adult EEG

f. Part 3 Normal Age Related Development

2. Complete Quiz 2

III. Module 3

A. Objectives

1. Recognize sleep patterns in normal pediatric EEG recordings.

2. Describe age appropriate appearance of patterns such as sleep spindles, POSTS, Vertex waves, K Complexes, and Hypnagogic and Hypnopompic Hypersynchrony.

3. Define the following sleep stages according to the American Association of Sleep Medicine:

a. W = Wakefulness

b. Stage N1 (NREM 1)

c. Stage N2 (NREM 2)

d. Stage N3 (NREM 3/slow wave sleep)

e. Stage R (REM Sleep)

4. Describe children’s sleep habits at various ages, according to the National Sleep Foundation.

B. Assignments

1. Complete Links:

a. Reading Material Lesson 3

b. ASET Article: Childhood Sleep Wake Disorders

c. Sleep Stages & Definitions

d. National Sleep Foundation

2. Complete Quiz 3

IV. Module 4

A. Objectives

1. Recognize and describe the abnormal pediatric EEG associated with:

a. Infantile Spasms

b. West’s Syndrome

c. Lennox-Gastaut Syndrome

d. Benign Juvenile Myoclonic Epilepsy

e. Benign Rolandic Epilepsy

f. Benign Occipital Epilepsy

g. Absence Seizures

2. Describe EEG patterns associated with:

a. Generalized and focal spikes/polyspikes

b. 3 Hz spike and wave and Slow spike and wave

c. Hypsarrhythmia and Electrodecremental events

3. List the benefits of activation procedures such as hyperventilation and sleep deprivation for certain seizure types.

B. Assignments

1. Read “Practical Approach…” text Pgs 218-257

2. Complete Links:

a. Reading Material 4

b. Video Presentation - Goodman

c. 2nd Video Presentation - Goodman

d. ASET Article: First Sz in a Child

e. ASET Article: JME

f. Compare and Contrast Doose Syndrome & Dravet

g. Epileptic Syndromes

3. Complete Assignment 2

4. Complete Quiz 4

V. Module 5

A. Objectives

1. Describe normal awake patterns in children 3 months to 18 years.

2. Recognize the abnormal pediatric EEG in patients with neurological disorders such as: Cerebrovascular, Traumatic, Infectious, Metabolic, Neoplastic.

3. Identify symptoms and patterns seen in the following:

a. Moya Moya Disease

b. Alternating Hemiplegia

c. Syncope 

d. Traumatic Brain Injury

e. Meningitis and Encephalitis

f. Congenital Herpes Encephalitis

g. Cytomegalic Virus

h. Rasmussen’s Encephalitis

i. MELAS

j. Agenesis of the Corpus Callosum

k. Tuberous Sclerosis

4. Identify Pediatric Sleep Disorders that resemble seizures: Parasomnias & sleep walking.

B. Assignments

1. Complete Links:

a. Lesson 5 Reading Material

b. Brain Injury Facts

c. Video: Moya Moya Disease

d. Language and Behavior Disorders

e. Periodic Patterns in Pediatric Patients

2. Complete Quiz 5

VI. Module 6

A. Objectives

1. Define Gestational age, Legal/Chronological age, and Conceptional Age.

2. Describe the implications of the Apgar Score, apnea, bradycardia, and reflux in the high risk infant.

3. Describe the technique and parameters used for recording neonatal EEG.

4. List the physiologic variables needed to differentiate sleep stages in the neonatal recording including EEG, EKG, EMG, EOG, and Respiration.

5. Recognize and describe the age dependent (CA 29 weeks to 48 weeks) EEG associated with:

a. Common background patterns (continuity, symmetry, synchrony)

b. Active & Quiet Sleep

c. Trace Alternant

d. Trace Discontinua

e. Active Moyenne

f. Sleep Spindles

g. Delta Brushes

h. Encoches frontales

B. Assignments

1. Complete Links:

a. Lesson 6 Reading Material

b. Required Reading ASET Article Neonatal EEG

c. APGAR Scoring

d. Skin Safety

e. Video Presentation Neonatal Technique

f. Pain in the Human Neonate

2. Complete Quiz 6

3. Complete Assignment 3

VII. Module 7

A. Objectives

1. Recognize abnormal patterns in neonates such as:

a. Burst-suppression

b. Excessive discontinuity

c. Abnormal asymmetry or asynchrony

d. Abnormal sharp waves and spikes

e. Neonatal Seizures

2. Recognize the clinical manifestations of neonatal seizures.

3. List the various etiology of neonatal seizure disorders such as:

a. Asphyxia, Hypocalcemia, Hypoglycemia/Hypernatremia

b. Intracranial hemorrhages, Infection, congenital malformations, inborn errors of metabolism, drug withdrawal, and anesthetic intoxication

4. Identify neonatal epilepsy syndromes.

5. Identify the usefulness of electroencephalography in identifying:

a. Interictal and ictal abnormalities

b. Prognostic implications and treatments

B. Assignments

1. Read “Practical Approach…” Pgs 315-327

2. Complete Links:

a. Video Presentation Pediatric Seizure Disorders

b. Presentation Handout for Pediatric Seizure Disorders

3. Complete Quiz 7

VIII. Module 8

A. Objectives

1. Define seizures, epilepsy, and epilepsy syndromes.

2. Explain why seizure classification is important.

3. Explain the clinical utility of imaging studies and how they correlate with EEG findings.

4. Identify focal and generalized abnormalities and EEG patterns that suggest specific syndromes.

B. Assignments

1. Complete Links:

a. Video Presentation Pediatric Classification

b. ASET Article: Pediatric Video Monitoring

c. Pediatric Case Studies

2. Complete Quiz 8

Grading Scale

91-100%     =  4.0   Excellent

86-90.9%    =  3.5

81-85.9%    =  3.0   Good

76-80.9%    =  2.5   Satisfactory and Passing

71-75.9%    =  2.0   Not Passing

66-70.9%    =  1.5

60-65.9%    =  1.0

0-59.9%      =  0.0  
Mandatory Course Components:
I. Module 1

A. Objectives

1. Explain the elements of age-appropriate pediatric care.

2. Identify the ages/stages of development and suggested best practices for technologists:

a. Infant: Birth to 1 year “Trust vs. Mistrust”

b. Toddler: 1-3 years “Autonomy vs. Shame and Doubt”

c. Pre-school: 4-7 years “Initiative vs. Guilt”

d. School age: 8-12 years “Industry vs. Inferiority”

e. Adolescence: 13 to 18 years “Identity vs. Role Confusion”

3. Describe measures that add to patient comfort and gain cooperation during the EEG procedure.

4. Explain ways to incorporate behavior techniques that add to patient comfort and gain cooperation during the EEG procedure.

B. Assignments

1. Complete Links:

a. ACNS Guideline 5

b. ASET Presentation: Pediatric Age Appropriate Care

c. ASET Slides Lesson 1

d. Poster: Pediatric EEG w/o Sedation

e. ASET Article: Pediatric Sedation vs Music Therapy

f. ASET Position Statement

g. Technical Tips

2. Complete Quiz 1

3. Complete Assignment 1

II. Module 2

A. Objectives

1. Describe normal awake patterns in children 3 months to 18 years.

2. Explain passive eye closure and its usefulness to view background activity.

3. Recognize Posterior Slow Waves of Youth.

4. Chart the development of normal awake posterior dominant rhythms.

5. Describe activation procedures such as sleep, photic stimulation, and hyperventilation.

6. Identify Photic driving in infants.

7. Recognize HV Buildup in children.

8. Identify normal variants commonly seen in children such as: Lambda & Mu Rhythm.

B. Assignments

1. Complete Links:

a. Reading Material Lesson 2

b. ASET Article: What is Normal?

c. ASET Article: EEG Maturation

d. Part 1 Neonatal EEG

e. Part 2 Infant, Pediatric, and Adult EEG

f. Part 3 Normal Age Related Development

2. Complete Quiz 2

III. Module 3

A. Objectives

1. Recognize sleep patterns in normal pediatric EEG recordings.

2. Describe age appropriate appearance of patterns such as sleep spindles, POSTS, Vertex waves, K Complexes, and Hypnagogic and Hypnopompic Hypersynchrony.

3. Define the following sleep stages according to the American Association of Sleep Medicine:

a. W = Wakefulness

b. Stage N1 (NREM 1)

c. Stage N2 (NREM 2)

d. Stage N3 (NREM 3/slow wave sleep)

e. Stage R (REM Sleep)

4. Describe children’s sleep habits at various ages, according to the National Sleep Foundation.

B. Assignments

1. Complete Links:

a. Reading Material Lesson 3

b. ASET Article: Childhood Sleep Wake Disorders

c. Sleep Stages & Definitions

d. National Sleep Foundation

2. Complete Quiz 3

IV. Module 4

A. Objectives

1. Recognize and describe the abnormal pediatric EEG associated with:

a. Infantile Spasms

b. West’s Syndrome

c. Lennox-Gastaut Syndrome

d. Benign Juvenile Myoclonic Epilepsy

e. Benign Rolandic Epilepsy

f. Benign Occipital Epilepsy

g. Absence Seizures

2. Describe EEG patterns associated with:

a. Generalized and focal spikes/polyspikes

b. 3 Hz spike and wave and Slow spike and wave

c. Hypsarrhythmia and Electrodecremental events

3. List the benefits of activation procedures such as hyperventilation and sleep deprivation for certain seizure types.

B. Assignments

1. Read “Practical Approach…” text Pgs 218-257

2. Complete Links:

a. Reading Material 4

b. Video Presentation - Goodman

c. 2nd Video Presentation - Goodman

d. ASET Article: First Sz in a Child

e. ASET Article: JME

f. Compare and Contrast Doose Syndrome & Dravet

g. Epileptic Syndromes

3. Complete Assignment 2

4. Complete Quiz 4

V. Module 5

A. Objectives

1. Describe normal awake patterns in children 3 months to 18 years.

2. Recognize the abnormal pediatric EEG in patients with neurological disorders such as: Cerebrovascular, Traumatic, Infectious, Metabolic, Neoplastic.

3. Identify symptoms and patterns seen in the following:

a. Moya Moya Disease

b. Alternating Hemiplegia

c. Syncope 

d. Traumatic Brain Injury

e. Meningitis and Encephalitis

f. Congenital Herpes Encephalitis

g. Cytomegalic Virus

h. Rasmussen’s Encephalitis

i. MELAS

j. Agenesis of the Corpus Callosum

k. Tuberous Sclerosis

4. Identify Pediatric Sleep Disorders that resemble seizures: Parasomnias & sleep walking.

B. Assignments

1. Complete Links:

a. Lesson 5 Reading Material

b. Brain Injury Facts

c. Video: Moya Moya Disease

d. Language and Behavior Disorders

e. Periodic Patterns in Pediatric Patients

2. Complete Quiz 5

VI. Module 6

A. Objectives

1. Define Gestational age, Legal/Chronological age, and Conceptional Age.

2. Describe the implications of the Apgar Score, apnea, bradycardia, and reflux in the high risk infant.

3. Describe the technique and parameters used for recording neonatal EEG.

4. List the physiologic variables needed to differentiate sleep stages in the neonatal recording including EEG, EKG, EMG, EOG, and Respiration.

5. Recognize and describe the age dependent (CA 29 weeks to 48 weeks) EEG associated with:

a. Common background patterns (continuity, symmetry, synchrony)

b. Active & Quiet Sleep

c. Trace Alternant

d. Trace Discontinua

e. Active Moyenne

f. Sleep Spindles

g. Delta Brushes

h. Encoches frontales

B. Assignments

1. Complete Links:

a. Lesson 6 Reading Material

b. Required Reading ASET Article Neonatal EEG

c. APGAR Scoring

d. Skin Safety

e. Video Presentation Neonatal Technique

f. Pain in the Human Neonate

2. Complete Quiz 6

3. Complete Assignment 3

VII. Module 7

A. Objectives

1. Recognize abnormal patterns in neonates such as:

a. Burst-suppression

b. Excessive discontinuity

c. Abnormal asymmetry or asynchrony

d. Abnormal sharp waves and spikes

e. Neonatal Seizures

2. Recognize the clinical manifestations of neonatal seizures.

3. List the various etiology of neonatal seizure disorders such as:

a. Asphyxia, Hypocalcemia, Hypoglycemia/Hypernatremia

b. Intracranial hemorrhages, Infection, congenital malformations, inborn errors of metabolism, drug withdrawal, and anesthetic intoxication

4. Identify neonatal epilepsy syndromes.

5. Identify the usefulness of electroencephalography in identifying:

a. Interictal and ictal abnormalities

b. Prognostic implications and treatments

B. Assignments

1. Read “Practical Approach…” Pgs 315-327

2. Complete Links:

a. Video Presentation Pediatric Seizure Disorders

b. Presentation Handout for Pediatric Seizure Disorders

3. Complete Quiz 7

VIII. Module 8

A. Objectives

1. Define seizures, epilepsy, and epilepsy syndromes.

2. Explain why seizure classification is important.

3. Explain the clinical utility of imaging studies and how they correlate with EEG findings.

4. Identify focal and generalized abnormalities and EEG patterns that suggest specific syndromes.

B. Assignments

1. Complete Links:

a. Video Presentation Pediatric Classification

b. ASET Article: Pediatric Video Monitoring

c. Pediatric Case Studies

2. Complete Quiz 8

 
Equivalent Courses:
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