So fun last week kicking off @EmoryNeurology #EEGLongitudinalCourse; couldn’t stump these smart 🧠s at all! They seemed to like this trusty #mnemonic I made as a PGY2, so here’s my 1st #tweetorial on using CSF-VOR to analyze the EEG background
@MonicaDhakar @RebeccaFasanoMD
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@MonicaDhakar @RebeccaFasanoMD
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There are many approaches, but the most important thing is to have *some* kind of system. I LOVE mnemonics and this one is easy to remember since CSF and VOR are in our neuro vocab! Note: this is not meant to be an all-inclusive discussion of the EEG background, just a start! 2/ 
C: CONTINUITY. Is the amplitude consistently >20 uV or do the waveforms “drop out” and become <20 uV for extended periods of time? Can be due to drug effect, and be sure to note the patient's age (discontinuity can be normal in neonates!) 3/
S: SYMMETRY. Are the L and R hemispheres symmetric with regards to frequency and amplitude of waveforms? Amplitudes may be slightly asymmetric but make a note of it if the difference is consistently >50% 4/
F: FREQUENCY. Count out those waves! In the best waking background, is it alpha (8-13 Hz), theta (4-8 Hz), delta (0.5-4 Hz), or beta (12-30 Hz)? A mix? Look for a posterior dominant rhythm, and count this during the most alert background state. 5/
V: VARIABILITY. Does the EEG change in appearance over time with regards to amplitude, frequency, or waveform morphology? A normal EEG should have plenty of variability and shouldn’t look exactly the same throughout the entire recording. 6/
O: ORGANIZATION. Is there an anteroposterior gradient with lower amplitude/faster frequencies anteriorly? 7/
R: REACTIVITY. Does the EEG change in response to external factors such as auditory or tactile stimuli or patient-related movements like eye closing/opening? The attenuation of the PDR with eye opening is one example of reactivity! 8/
Here's a snapshot of a normal EEG that shows all these elements; see if you can identify them all! 9/
And there you have it! Go CSF-VORth, and have fun reading those EEGs! 10/end
