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J Korean Neurol Assoc. 2003 Jun;21(3):225-238. Korean. Review.
Hong SB , Jung KY .
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea.

Although neuroimaging techniques and other diagnostic procedures has been developed, electroencephalography(EEG) is still very important for the evaluation of various brain diseases and functional studies of human brain. EEG is formed mainly by spatial and temporal summations of postsynaptic potentials generated from a large population of pyramidal cells that can be considered as a collection of oscillating dipoles. EEG shows continuous rhythmic oscillation depending on sleep-waking state. Alpha rhythms are generated in cortical areas acting as epicenters with local spread, although the precise cellular mechanism is still unknown. It's been known that neurons in the nucleus reticular thalami are the pacemakers of sleep spindle. Alterations in the circuit of the reticular nuclei-thalamocortical relay neuron-cortical neuron are responsible for generalized spike and wave complexes. At the intracellular level, large paroxysmal depolarizing shifts produce focal epileptic spikes. Slow waves of EEG appear to be related to thalamocortical and/or corticothalamic deafferentation. The interpretation of routine EEG requires a well training from a qualified EEG teacher and reading adequate amount of EEG under supervision. Frequent misinterpretations of routine EEG have been observed in both local clinics and general hospitals. The most common findings of normal routine EEG misinterpreted as abnormal are normal variants and artifacts of various sources. There are considerable variations of normal EEG rhythms and pseudoepileptiform discharges. Eyeball movements produce prominent or subtle EEG changes over the frontal regions that are sometimes hard to be differentiated from abnormal slow waves over that region. Systematic approach was described for a good interpretation of routine EEG.

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