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When you edit a chart, you use the Chart Designer to view and edit the preview of the chart The structure of the Chart Designer window has three areas: chart preview (left side of the screen), list of elements (top-right side of the screen), and property area (bottom-left side of screen), as identified in the Figure 6-1 Depending on the Chart Designer feature you are using, these sections can switch sides of the window If you are going through the wizard process, the chart preview appears on the right side of the window; if you are using the Refine mode, the chart preview appears on the left The following list describes the three areas: Chart preview Shows an example chart that displays the values and properties that you set New charts have five data series and six categories by default, regardless of how the data provider is structured The important thing to remember is that the preview does not correspond to the results after publishing The data series and data categories are only sample data used to show you what the effects of formatting are You see the actual data only after it has been published So, focus on the format rather than the actual data and information List of elements Contains all elements of a chart These elements are partially ordered in logical groups You can expand these groups by clicking the plus sign in

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The electroencephalographic examination, for many years a standard laboratory procedure in the study of all forms of cerebral disease, has to a large extent been supplanted by CT and MRI Nevertheless, it continues to be an essential part of the study of patients with seizures and those suspected of having seizures It is also used in evaluating the cerebral effects of many systemic metabolic diseases, in the study of sleep, and in the operating room to monitor cerebral activity in anesthetized patients For a few diseases, such as subacute spongiform encephalopathy, it can be the de ning laboratory test It is described here in some detail, since it cannot suitably be assigned to any other single chapter The electroencephalograph records spontaneous electrical ac-

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tivity generated in the cerebral cortex This activity re ects the electrical currents that ow in the extracellular spaces of the brain, and these re ect the summated effects of innumerable excitatory and inhibitory synaptic potentials upon cortical neurons This spontaneous activity of cortical neurons is much in uenced and synchronized by subcortical structures, particularly the thalamus and high brainstem reticular formation Afferent impulses from these deep structures are probably responsible for entraining cortical neurons to produce characteristic rhythmic brain-wave patterns, such as alpha rhythm and sleep spindles (see further on) Electrodes, which are solder or silver-silver chloride discs 05 cm in diameter, are attached to the scalp by means of adhesive material such as collodion and conductive paste (or conductive paste alone) The electroencephalograph has 8 to 24 or more amplifying units capable of recording from many areas of the scalp at the same time The ampli ed brain rhythms are strong enough to move an ink-writing pen, which produces waveforms of brain activity in the frequency range of 05 to 30 Hz (cycles per second) on paper moving at a standard speed of 3 cm/s Alternatively, and more often now, the signal is digitally processed and displayed on a computer screen The resulting electroencephalogram (EEG), essentially a voltage-versus-time graph, is recorded as a number of parallel wavy lines, or channels (Fig 2-3A) Each channel represents the electrical potential between two electrodes (a common or ground electrode may be used as one recording site, but the channel still represents a bipolar recording) The channels are arranged for viewing into standard montages that generally compare the activity from one region of the cerebral cortex to that from the corresponding region of the opposite side Conventional ink-written EEGs are gradually being replaced by a digital format, in which the digitized waveforms are viewed on the computer screen As mentioned, the digital electroencelphalograph has the great advantage of providing many more channels than the earlier type as well as exibility in viewing the result, and it requires practically no storage space Patients are usually examined with their eyes closed and while relaxed in a comfortable chair or bed The ordinary EEG, therefore, represents the electrocerebral activity that is recorded under restricted circumstances, usually during the waking state, from several parts of the cerebral convexities during an almost in nitesimal segment of the person s life In addition to the resting record, a number of so-called activating procedures are usually employed 1 The patient is asked to breathe deeply 20 times a minute for 3 min Hyperventilation, through a mechanism yet to be determined, may activate characteristic seizure patterns or other abnormalities A powerful strobe light is placed about 15 in from the patient s eyes and ashed at frequencies of 1 to 20/s with the patient s eyes open and closed The occipital EEG leads may then show waves corresponding to each ash of light (photic driving, Fig 2-3B) or abnormal discharges (Fig 2-3C) The EEG is recorded after the patient is allowed to fall asleep naturally or following sedative drugs given by mouth or by vein Sleep is extremely helpful in bringing out abnormalities, especially where temporal lobe epilepsy and certain other seizures are suspected.