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This is one setting that I normally have the system automatically address, but you can change the number and position of the range symbols tick marks For value axes, you can define how many major and minor tick marks are displayed on the scale To execute this configuration, click the required axis in the chart preview or select the corresponding entry in the list of elements Then, in the property Gridline | Major Ticks | Major Tick Gap (shown in the illustration at right), enter an integer greater than zero, for example, 2 This specifies the interval at which major lines are displayed You can also change the appearance of the tick marks in this element This is also the case for category axes Another area where the positioning can be left up to the system is in the process of setting up the category labels Work with the system defaults and make sure that the title that you will be using is consistent and functional If you do decide to make changes manually, you can define on the category axes whether all category labels are to be displayed, or if not, which

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transient high-voltage waveforms that have a pointed peak at conventional paper speeds and a duration of 20 to 70 ms (Fig 2-3D) Spikes or sharp waves that occur interictally in epileptics or in individuals with a genetic disposition to seizures are referred to as epileptiform discharges These abnormal fast and slow waves may be combined, and when a series of them interrupts relatively normal EEG patterns in a paroxysmal fashion, they are highly suggestive of epilepsy The ones associated with absence seizures are 3-per-second spike-andwave complexes that characteristically appear in all leads of the EEG simultaneously and disappear almost as suddenly at the end of the seizure (Fig 2-3E) This nding led to the theoretic localization of a pacemaker for primary generalized seizure discharges in the thalamus or other deep gray structures ( centrencephalic seizures ), but such a center has not been veri ed anatomically or physiologically The most pathologic nding of all is the replacement of the normal EEG pattern by electrocerebral silence, meaning that the electrical activity of the cortical mantle, recorded from the scalp, is absent Artifacts of various types should be seen as the ampli er gains are increased; if not, there is a risk that the leads are not properly connected to the machine Acute intoxication with high levels of drugs such as barbiturates can produce this sort of isoelectric EEG (Fig 2-3I) Moreover, in the absence of nervous system depressants or extreme degrees of hypothermia, a record that is at (less than 2 mV except for artifacts) over all parts of the head is almost always a result of profound cerebral hypoxia or ischemia or of trauma and raised intracranial pressure Such a patient without EEG activity, brainstem re exes, and spontaneous respiratory or muscular activity of any kind for 6 h or more is said to be brain dead The brain of such a patient is largely necrotic, and there is no chance of neurologic recovery The topic of brain death is discussed further in Chap 17.

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Some of the different types of seizure patterns are shown in Fig 2-3C, D, and E The absence, myoclonic, and grand mal patterns correlate closely with the clinical seizure type and may be present in milder form in the interictal EEG A fact of importance is that, between seizures, a single EEG recording will show a normal pattern in as many as 30 percent of patients with absence seizures and 50 percent of those with grand mal epilepsy (this percentage is less with repeated recordings) Anticonvulsant therapy also tends to diminish the interictal EEG abnormalities The records of another 30 to 40 percent of epileptics, though abnormal between seizures, are nonspeci cally so; therefore the diagnosis of epilepsy can be made only by the correct interpretation of clinical data in relation to the EEG abnormality Brain Tumor, Abscess, Subdural Hematoma, and Encephalitis Intracranial mass lesions are associated with characteristic abnormalities in the EEG, depending on their type and location, in some 90 percent of patients In addition to diffuse changes, the classic abnormalities comprise focal or localized slow-wave activity (usually delta, as in Fig 2-3F) or, occasionally, seizure activity and decreased amplitude and synchronization of normal rhythms Although the EEG may be diagnostically helpful in cases of brain tumor or abscess, particularly when integrated with the other laboratory and clinical ndings, reliance is now placed almost exclusively on CT and MRI However, the EEG remains of considerable value in the diagnosis of herpes simplex encephalitis in which periodic highvoltage sharp waves and slow-wave complexes at intervals of 2 to 3 per second in the temporal regions are characteristic The other infectious encephalitides are often associated with sharp or spike activity, particularly if there have been seizures The highly characteristic pattern of sharp waves that are almost periodic in Creutzfeldt-Jakob disease is shown in Fig 2-3G Cerebrovascular Disease The EEG is now little used in the differential diagnosis of stroke Its main practical value lies in the ability to distinguish an acute lesion in the distribution of the internal carotid or other major cerebral artery, which produces an area of slowing in the appropriate region, from lacunar infarction deep in the cerebrum or brainstem in which the surface EEG is usually normal despite prominent clinical abnormalities After 3 to 6 months, in roughly 50 percent of patients with infarction in the territory of the middle cerebral artery, the EEG becomes normal Perhaps half these patients will have had normal EEGs even in the week or two following the stroke A persistent abnormality is generally associated with a poor prognosis for further recovery Large lesions of the diencephalon or midbrain produce bilaterally synchronous slow waves, but those of the pons and medulla (ie, below the mesencephalon) are usually associated with a normal or nearnormal EEG pattern despite catastrophic clinical changes Cerebral Trauma A brief episode of cerebral concussion in animals is accompanied by a transitory disturbance in the EEG, but in humans this is usually no longer evident by the time a recording can be made Large cerebral contusions produce EEG changes similar to those described for cerebral infarction Diffuse changes often give way to focal ones, especially if the lesions are on the superolateral surfaces of the brain, and these, in turn, usually disappear over a period of weeks or months Sharp waves or spikes sometimes emerge as the focal slow-wave abnormality resolves and may precede the occurrence of posttraumatic epilepsy; serial EEGs may.