[논문]임상뇌파검사의 일반적인 관행

현순철; 김동엽

doi:10.15324/kjcls.2021.53.4.296

임상뇌파검사의 일반적인 관행
Common Practices in Clinical Electroencephalography 원문보기

Korean journal of clinical laboratory science : KJCLS = 대한임상검사과학회지, v.53 no.4, 2021년, pp.296 - 308

현순철 (삼성서울병원 신경과) , 김동엽 (삼성서울병원 신경과)

초록
AI-Helper

뇌파검사는 뇌전증을 가장 정확하고 빠르게 진단한다. 또한 뇌의 기능과 발작을 장소의 구애를 받지 않으면서 실시간으로 평가할 수 있는 중요한 검사이다. 뇌전증 분야에서는 뇌파검사지식과 임상경험이 많은 임상병리사가 PA를 하는 것이 적합하다. 전극 부착 방법은 국제 표준 10-20법을 기반으로 한다. 뇌파 판독은 주로 LB몽타주로 판독한다. 하지만 한 가지 몽타주만 이용하여 판독하는 것은 오류를 범할 수 있기 때문에, 상황에 맞게 2개 이상의 몽타주를 병용해서 판독한다. 뇌파에서 전위는 등고선의 형태로 보인다. 뇌파 진단에서 가장 중요한 원리는 과잉 판독이 아닌 과소 판독이다. 뇌파를 반복해서 기록할수록 더욱 민감하게 판독할 수 있다. 좋은 뇌파 판독을 위해서는 양질의 좋은 뇌파가 기록되어야 한다. 그러기 위해선 신경과 의사와 뇌파 기사의 관계가 매우 중요하다. 앞으로는 많은 판독 경험과 임상적 실무지식을 갖춘 임상병리사의 활동영역이 좀 더 확대되길 기대한다.

Abstract ▼ AI-Helper

Electroencephalography (EEG) provides the most accurate and quickest diagnosis of epilepsy. It is also an important examination for the real-time evaluation of brain function and seizures, no matter where. In the field of epilepsy, it is appropriate for a clinical pathologist with considerable knowledge of EEG and clinical experience to perform the role of a Physician Assistant (PA). The electrode attachment method is based on the international 10-20 system. The EEG reading is mainly taken by longitudinal bipolar montage. However, a reading using only one montage may result in an error. Hence, two or more montages should be used for readings according to the clinical situation. In the EEG, electric potentials are seen as contour lines. The most important principle in EEG reading is under-reading, not over-reading. The higher the repetitions of the EEG recording, the greater the sensitivity of the reading. For a good reading, the EEG recording must be of good quality. So, the relationship between the neurologist and the EEG technician is very important. In the future, it is expected that the field of activities of the EEG technician with abundant EEG reading experience and clinical practical knowledge will be further expanded.

주제어

표/그림 (11)

그림 Figure 1. International 10-20 electrode position of electroencephalogram.
그림 Figure 2. Image of portable medical fume extractor with HEPA filter (Model #SS-300-MED; Sentry Air Systems, https://www.sentryair.com). Abbreviation: HEPA, high-efficiency particulate air.
그림 Figure 3. Examples of most commonly used bipolar and referential montages (A, double banana; B, transverse bipolar; C, reference derivation).
그림 Figure 4. Differences between two points of the contour line. Phase reversal at kissing point (A) of negative and positive phase.
그림 Figure 5. Contour line of electrical potential.
그림 Figure 6. Location of electrodes in international 10-20 system. Abbreviations: Fp1, Frontopolar; F7, Frontotemporal; T7, Mid-temporal; P7, Posterior temporal; F3, Frontal; C3, Central; P3, Parietal; O1, Occipital.
그림 Figure 7. Stereoencephalography electrode implantation.
그림 Figure 8. Stereotactic robot for SEEG surgery (Model ROSA ONE Brain, Zimmer-Medtech, https://www.zimmerbiomet.com/en/productsand- solutions/zb-edge/robotics/rosa-brain.html).
그림 Figure 9. Image of EEG by eye movements. A: Looking at the left side, B: looking at the right side.
그림 Figure 10. Image of EEG by eye movements. A: Looking upward, B: looking downward, C: closing eyes.
그림 Figure 11. Image of EEG by blinking.

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표제어: PCR

동의어: Packet Collision Rate

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