Media file 4: This is an example of "slow alpha variant." The patient's alpha rhythm at 12 Hz is seen in the second half of the sample.. Media file 1: The earliest indication of transiti
Trang 1VỎ NÃO
Trang 2Các tế bào vỏ não
Trang 3BÓ THÁP
- Bắt nguồn từ tế bào tháp ở lớp III.
+ Tháp chéo (90%).
+ Tháp thẳng (10%)
Trang 4BÓ GỐI
- Bắt nguồn từ tế bào tháp ở lớp III.
Tận cùng sợi trục tiếp xúc với nhân các dây thần kinh sọ não.
Chi phối vận động các
cơ vùng đầu mặt cổ
Trang 7ĐỊNH KHU VẬN ĐỘNG
Trang 9ĐỊNH KHU VỎ NÃO
Trang 11ĐIỆN NÃO (Electroencephalography)
Trang 12CÁC ĐẠO TRÌNH MẮC NỐI TIẾP
14 - 16
Trang 13CÁC ĐẠO TRÌNH MẮC SONG SONG
Chuyển đạo:
1 3 5 7 9 11 13 15
Trang 19PHÂN LOẠI SÓNG ĐIỆN NÃO
- Sóng nhanh: tần số ≥ 7 chu kỳ/giây.
+ α ≥ 7 – 12 chu kỳ/giây + β > 12 chu kỳ/giây.
- Sóng chậm: tần số < 7 chu kỳ/giây.
+ θ ≤ 3 – 7 chu kỳ/giây.
+ δ < 3 chu kỳ/giây.
Trang 26ĐIỆN NÃO BÌNH THƯỜNG
BIÊN SOẠN: TS ĐÀO MAI LUYẾN
Trang 27Media file 1: A 10-second segment showing a well-formed and well-regulated alpha rhythm at 9 Hz Note that it is very regular, rhythmic, waxing and waning, and posterior dominant The contrast between the first and second halves of the page illustrates the reactivity of a normal alpha rhythm, with attenuation upon eye opening
Trang 28Media file 2: Fleeting alpha At times, as shown here, the alpha rhythm can be identified only in very brief bursts and often immediately after eye closure If normal in frequency, this is normal
Trang 29Media file 3: This is an example of an alpha rhythm with a wider distribution than is typical If frequency and reactivity are normal, this is another variation of normal A similar EEG pattern can be seen in patients in a coma (ie, alpha coma), but in these situations it is usually unreactive
Trang 30Media file 4: This is an example of "slow alpha variant." The patient's alpha rhythm at 12 Hz is seen in the
second half of the sample The first half shows a subharmonic at half that frequency, and this is the "slow alpha variant
Trang 31Media file 5: A sample of awake EEG showing the normal or usual amount of beta activity As shown here, beta activity is often easier to identify during relaxed wakefulness or early drowsiness
Trang 32Media file 6: Mu rhythm over the left (greater than right) central region To be absolutely certain that this is a mu rhythm, reactivity should be tested However, morphology (not absolutely typical but fairly so), frequency, and distribution strongly suggest that this is a mu rhythm
Trang 33Media file 7: An example of a typical normal alpha rhythm, showing clear attenuation upon eye opening (second half of page)
Trang 34Media file 8: This is the normal amount of beta activity, frontally predominant, with waxing and waning amplitude
Trang 35Media file 9: Alpha rhythm with somewhat "spiky" or sharply contoured morphology When fragmented (eg, in drowsiness), this can be misinterpreted as sharp waves.
Trang 36ĐIỆN NÃO TRONG GIẤC NGỦ
Trang 39A Electroencephalography
(EEG)
Trang 40Media file 1: The earliest indication of transition from wakefulness to stage I sleep (drowsiness) is shown here and usually consists of a combination of (1) drop out of alpha activity and (2) slow rolling eye movements
Trang 41Media file 2: Slow rolling (lateral) eye movements during stage I sleep Like faster lateral eye movements, slow ones are best seen at the F7 and F8 electrodes, with the corneal positivity indicating the side of gaze
Trang 42B Sleep stage I EEG sample
Trang 43Media file 3: On this transverse montage, typical vertex sharp transients are seen In contrast to K complexes, these are narrow (brief) and more focal, with a maximum negativity at the mid line (Cz and to a lesser degree Fz) These are seen in sleep stages I and II
Trang 44Media file 4: Vertex waves are focal sharp transients typically best seen on transverse montages (through the midline) and would be missed on this longitudinal bipolar montage if it did not include midline channels (Fz-Cz-Pz) Vertex waves are seen in sleep stages I and II
Trang 45C Sleep stage II EEG sample
Trang 46Media file 6: This shows a K complex, typically a high-amplitude long-duration biphasic waveform with
overriding spindle This is a transverse montage, which shows the typical maximum (manifested by a "phase reversal") at the midline
Trang 47Media file 5: Positive occipital sharp transients of sleep (POSTS) are seen in both occipital regions, with their typical characteristics contained in their name They also have morphology classically described as "reverse check mark" and often occur in consecutive runs of several seconds, as shown here
Trang 48Media file 10: A mixture of spindles (ie, bicentral short-lived rhythmic 14 Hz bursts) and positive occipital sharp transients of sleep (POSTS) can be seen POSTS occur in stage I, but the presence of spindles is "diagnostic" of stage II
Trang 49D Sleep stage III EEG sample
Trang 50Media file 7: Typical sleep spindles with short-lived waxing and waning 15-Hz activity maximum in the frontocentral regions Note the associated slow (theta) activity that also characterizes stage II sleep
Trang 51Media file 8: Vertex sharp transients This transverse montage illustrates the maximum negativity (manifested by
a negative phase reversal) at the midline The location is similar to that of K complexes, but these are shorter (narrower) and more localized
Trang 52Media file 11: A mixture of positive occipital sharp transients of sleep (POSTS) and spindles (fronto-central lived rhythmic 14-Hz bursts) can be seen
Trang 53short-E.Sleep stage IV EEG sample
Trang 54Media file 13: Slow wave sleep with predominantly delta activity
Trang 55Media file 12: Slow wave sleep with predominantly delta activity, especially in the first half
Trang 56P Rapid eye movement sleep EEG
sample
Trang 57Media file 16: In addition to rapid eye movements, this rapid eye movement sleep record is characterized by brief fragments of alpha rhythm (first half) and central saw tooth waves (second half)
Trang 58Media file 17: This is a good example of saw tooth waves seen in rapid eye movement sleep and their "notched" morphology
Trang 59Media file 15: Typical saccadic eye movements of rapid eye movement sleep are shown, with lateral rectus
"spikes" seen just preceding the lateral abducting eye movements
Trang 60Media file 14: Rapid eye movement sleep with rapid (saccadic) eye movements While muscle "atonia" cannot be proven without a dedicated electromyogram (EMG) channel, certainly EMG artifact is absent with a "quiet"
recording Also, no alpha rhythm is present that would suggest wakefulness
Trang 61Media file 18: This is a good example of saw tooth waves seen in rapid eye movement sleep and their "notched" morphology, best seen here in the Cz-Pz (last) channel
Trang 62Media file 9: K complex, with its typical characteristics: high-amplitude, widespread, broad, diphasic slow
transient with overriding spindle On the longitudinal montage (left), the K complex appears to be generalized However, the transverse montage clearly shows that the maximum (phase reversal) is at the midline (Fz and Cz)
Trang 63Media file 19: This illustrates the typical appearance of saw tooth waves on a polysomnogram (PSG) display, equivalent to 1 cm/s
Trang 64EEG bệnh lý