Physician Video Ambulatory EEG Monitoring Instruction Manual

Transcription

1 Physician Video Ambulatory EEG Monitoring Instruction Manual Global Neuro-Diagnostics 2670 Firewheel Drive, Suite B Flower Mound, TX Global Neuro-Diagnostics (8/11/16)

2 CONTENTS Using EEG Server Data Page 3 Persyst Spike and Seizure Detection Definitions.... Page 6 Guide for Spike Review Page 8 Review Screen Instructions Page Navigation Options 1.2 Changing the Playback Speed 1.3 Switching to Full Screen Mode 1.4 Using Study Toolbar to Navigate Through Study 1.5 Using Waveform Cursors Tool 1.6 Performing Screen Capture 1.7 Printing Trace Window ATTACHED: Sample Technical Description Questions Regarding: Login Assistance/ Study Uploads & Documents Amelia Mendoza Data Coordinator x100 (office) amelia.mendoza@globalneuro.com IT/ Server Troubleshooting John Tran Systems Administrator x111 (office) john.tran@globalneuro.com Spike Detection Donna Bray R.EEG/EPT.,CLTM Director of Technical Operations ext 352 donna.bray@globalneuro.com 2 Global Neuro-Diagnostics (8/11/16)

3 USING EEG DATA SERVER Using your web browser, i.e. Internet Explorer go to Click on Physician Login from the Main Menu on the right side of screen You must download the Citrix Client and run and install the application prior to going to the EEG Data Server Login. Once the program is installed you may proceed to Login Once Citrix is downloaded, click on EEG Cloud Based Server Login button Click Skip to Log On (if applicable) Type in your username and password, then press Log In. o Login: Username (first initial of first name and last name all together and lowercase) Example: Darren Hall username: dhall Password: global o To create your own password, click on Settings then click Change Password. Type old password global and new password in twice on designated lines then OK to confirm 3 Global Neuro-Diagnostics (8/11/16)

4 A screen will appear with two Icons: NeuroWorks EEG and Patient Documents o Click on NeuroWorks EEG to access the entire study with video and click on Patient Documents to access the following: Patient Log, Tech Report, Technical Description Click NeuroWorks EEG icon to open EEG studies - The study will open and you can read the study as usual Click on the camera icon to open the 2 camera video review If you would like to open the Patient Event Log or Tech Report, minimize the EEG window and then Click on Patient Documents icon o You will then be presented with all of the patient documents available for viewing o Double-Click on the document you want to open o You can now view or minimize this document and continue reading your EEG study, and flip back and forth if you desire. When you finish reading the study, close the windows you have open. NOTE: When you close the NeuroWorks EEG window it can take up to 20 seconds. 4 Global Neuro-Diagnostics (8/11/16)

5 PERSYST SPIKE AND SEIZURE DETECTION DEFINITIONS To access these views. Click on Analysis > tools > Magic Marker Tool Bar. This will give you the option to view EEG trend files Common trend views described below: Seizure Probability: Displays a Seizure Probability Index generated by the Reveal Rosetta seizure detection algorithm. The higher the deflection, the higher the probability assigned to the seizure by the Rosetta seizure detector. Rhythmicity Spectrogram, Left and Right Hemisphere: Displays only the rhythmic/periodic components of the EEG waveform so that seizure activity and morphology can be visualized. 5 Global Neuro-Diagnostics (8/11/16)

6 Asymmetry, Relative Spectrogram (REASI Spectrogram): This spectrogram shows the difference between a left-hemisphere spectrogram and a right-hemisphere spectrogram (between homologous electrodes). This provides additional information about an asymmetry noted in the aeeg trends, e.g., at what frequency is the asymmetry most prominent? The vertical axis is frequency, and increasing asymmetry is indicated in red for right-weighted and blue for left-weighted asymmetries. The color spectrum has been carefully selected to avoid color-preference (e.g., red doesn t appear brighter/more intense than blue). Peak Envelope 2-20 Hz Left + Right: This trend shows the amplitude of EEG within the 2-20 Hz frequency range. Seizure activity often occurs within this frequency range, so it is helpful for seizure review. Right Peak Envelope Power is shown in red, and Left Peak Envelope Power is shown in blue. aeeg Left + Right: This trend has its origin in the CFAM (cerebral function monitors) of the 1960 s, and only deflects with changes in EEG amplitude. It represents only EEG amplitude information, and does not depict information concerning frequency or rhythmicity. It is useful for trending overall amplitude changes observed in many seizure types, and also for noting changes in suppression-burst patterns. R2D2 Double Distance trends: A limited version of Rhythmicity Spectrogram (which used to be called R2D2 or Rhythmic Run Detection and Display). The double distance version only contains the channels used by the Rosetta Seizure Detector (F7-CZ, F8-Cz, T5-CZ, T6-CZ, F7- T5, F8-T6) 6 Global Neuro-Diagnostics (8/11/16)

7 GUIDE FOR SPIKE REVIEW Select Magic Marker (Insight II standalone). You will be brought to an EEG screen You may jump through the spikes (will be listed in comment box to the right) before proceeding to Spike Clustering From the Tools Menu, select Spike Review. Spikes may be reviewed rapidly by selecting the corresponding tab above the EEG Watch the Flash Tutorial at the following web address for specifics on how to use the Spike Review product: (Image 1) Spike Review is also a standalone program if you choose to review Spikes by electrode site. Select Spike Review from the dropdown menu in Tools. (Image 2) Image 1- How to get to Spike Review Image 2- Spike Review 7 Global Neuro-Diagnostics (8/11/16)

8 REVIEW SCREEN INSTRUCTIONS 1.1 Using the Review Toolbar to Navigate Through a Study Click the Event button (may also appear as Page depending on the selected option) to display navigation options: Page Moves through the study page by page. When navigating a study by page, the playback speed refers to pages per second. (For example, a playback speed of 2 means 2 pages per second.) Scroll Scroll navigation mode is supported for single steps and automatic playback. In this mode, the time mark remains fixed while signal traces are scrolled and video is playing at high rate. Scrolling speed is controllable with the same Speed control as the paging rate. Use the spacebar (as with other navigation modes) to start/stop playback. When navigating a study using Scroll, the playback speed refers to the number of times the video is sped up. (For example, a playback speed of 2 means video will play at twice the actual speed.) 8 Global Neuro-Diagnostics (8/11/16)

9 Event Moves to the next note starting at the time marker position and selects the note. When navigating a study by event, the playback speed refers to the number of seconds per event. (For example, a playback speed of 0.5 means each event is displayed for two seconds.) Event of Same Type Go to Event (Ctrl+G) Moves to the next event of the same type (i.e. Spike, Eyes Open). Lets you choose an event from a list of scored events. 1.2 Changing the Playback Speed Use the Speed control on the Review toolbar to increase or decrease the playback speed: Click the arrow keys to increase or decrease the playback speed. Click the displayed number to highlight it and then type a different playback speed. Press + or - on the numeric pad on the keyboard to increase or decrease the playback speed. 1.3 Switching to Full Screen Mode You can display the trace window in full screen mode during acquisition or review. To display the trace window in full screen mode or return it to normal mode: Press CTRL + F11 OR Choose View > Full Screen Maximize your Window by hiding the Analysis toolbar. This typically pops up on new user accounts To hide the Analysis tool bar MAGIC TOOLBAR = go to top of page and click on ANALYSIS click on other tools- un check MAGIC TOOLBAR. For proper viewing on the computer screen it may be necessary to calibrate the screen size. This is easily done by clicking Edit on the upper left of the Tool bar, 9 Global Neuro-Diagnostics (8/11/16)

10 select Calibrate. A drop down menu will display a list of computer screen sizes. Select the one that works best for your desired display. NOTE: Use EDIT toolbar and SETTINGS to change the montgage. These will not save setting changes or any Montage created. Global Neuro can create MONTAGES specifically for a user as well as Workspace settings (background color grid lines etc.) 1.4 Using the Study Toolbar to Navigate Through a Study A small Indicator Arrow shows your current position relative to the complete study. The vertical lines (note bands) on the Progress bar indicate the position of Notes in the study. NOTE: The dark blue bar at the bottom of the Study toolbar changes to purple where there is squeezed video. 10 Global Neuro-Diagnostics (8/11/16)

11 1.5 Using the Waveform Cursors Tool The Waveform Cursors button on the Review toolbar can be used to compare values of a waveform at various points. To use the waveform cursors tool: Click the Waveform Cursors button. Click a point in a waveform. The waveform cursor and info box appear. Move the info box to a convenient viewing position. Move the waveform cursor along the wave. As you do, the values in the info box update to show those at the point indicated in the waveform 1.6 Performing a Screen Capture Navigate to the screen/page you want to capture. Press the Screen Capture button. The screen capture is stored in the clipboard. You can now use Shift + Insert or Ctrl + V standard Windows keys to paste it into any container that supports bitmapped images (for example, Word or MSPaint). You can also use the right-click menu, choose Paste, and paste the image where you want. 11 Global Neuro-Diagnostics (8/11/16)

12 1.7 Printing the Trace Window You can choose which trace items will be printed, as well as customize the thickness of the lines and the font weights and sizes. To select which trace items to print: Choose File > Page Setup. The Page Setup box opens. Below Include In Printout, select the items you want included in the printout. Below Line Thickness, choose the thickness of various lines in the trace. Below Font Weight and Size, choose the font weight (bold, normal, light etc.) and the font size for the header, channel labels, gains and footer. Click OK. To print the Trace window: Navigate to the place in the Trace window that you want to print. Choose File > Print. 12 Global Neuro-Diagnostics (8/11/16)