John Libbey Eurotext

Learn to interpret voltage maps: an atlas of topographies Volume 24, issue 2, April 2022

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Authors
1 Neurobiology Research Unit, Department of Neurology,Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
2 Research Department, BESA GmbH, Gräfelfing, Germany
3 Department of Clinical Neurophysiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
4 Department of Clinical Neurophysiology, Danish Epilepsy Centre, Dianalund, Denmark
5 Department of Clinical Neurophysiology, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
* Correspondence: Sándor Beniczky Visby Allé 5, 4293 Dianalund, Denmark

Describing the location of EEG abnormalities, such as interictal epileptiform discharges, is an important step in the interpretation of EEG recordings and has clinical relevance, as it is expected to point out the region of the brain generating these abnormal signals. Traditionally, the location is reported by specifying the area on the scalp where maximum negativity is located. However, this only reflects the correct localization in the brain when the cortical generator is located on the convexity (radial orientation). When the cortical generator is in the wall of a sulcus (tangential orientation), due to current flow (volume conduction), the maximum negativity is not over the generator, but at a distance from it. Voltage maps are widely available in most EEG reader software programs. Simple rules for reading voltage maps help to estimate the orientation and location of the source in the brain, avoiding false lateralization and false localization. In this seminar in epileptology, using a didactic approach, we explain how to read voltage maps and provide an atlas of voltage maps.

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