Wednesday, January 30, 2019

Neurophysiology 101: Learning the 10/20 system of head measurement and lead placement: How and Why





Many years ago, the ABRET EEG exam included an oral exam which included several sections, including record review, EEG pattern recognition and a demonstration of skill at measuring a head and placing leads accurately.  When I took the exam in 1980, volunteer subjects served as the candidates’ patients, and we actually ran a real EEG recording as part of the exam.  Eventually, the live subject process was no longer practical and ABRET substituted a “Sam” mannequin head, and candidate had to measure and apply leads to Sam instead.

In more recent years, the oral section of the ABRET exam ended for many valid reasons, and a two-part, written only exam replaced the oral exam.  For the past year, the EEG registry exam has been offered in one-part. 

Once the exam no longer included a practical demonstration of head measurement and lead placement skills, an apparent misconception surfaced, that this was not an important part of the EEG recording process.  However, both ABRET and ASET have always stressed that measuring the patient’s head prior to lead placement is an essential part of the patient set-up. 
Occasionally, an attendee at the ASET EEG Boot Camp inquires about a 10/20 head measurement/lead placement workshop as part of the seminar.  We used to include such a workshop but it was very difficult to maintain and ship enough Sam heads to make this workshop “work”.  We also found that many seminar attendees were not interested in participating.  So, in recent years, we replaced that time in the seminar with additional lectures and instrumentation workshops.  But, once again, I would like to emphasize that we at ASET promote head measurement as a very important part of the lead placement process, and accurate electrode placement is vital!

There is a full on-line curriculum of EEG coursework created by ASET and available as individual courses on the ASET website.  One of the courses is EEG 202: Electrodes, Electrode Placement and Application.  I am pleased to announce that we have just upgraded the content of this course!  
Maureen Carroll, the ASET On-line Course Developer, worked on creating a professional video tutorial on the skills of head measurement and lead placement.  She spent many hours scripting the video, and working with a media studio to film the demonstration.  This video is 40 minutes in duration and offers a step by step overview of the process, and has been uploaded as a lesson in the on-line course. 

I can highly recommend this course for entry level technologists and trainees!  You will benefit from the coaching and detail included.  Enrollees can revisit the video as often as they wish while learning this skill.  The course offers 20 ASET CEUs, meaning that there is at least 20 contact hours of course material, and the registration fee is $199 for ASET members and $299 for non-members. To view the course in our on-line store, please use this link:  ASETon-line EEG courses