The electroencephalogram (EEG) represents the electrical activity of the cerebral cortex recorded between two electrodes placed on the scalp. This signal is filtered through the skull; it represents the potential difference between the two electrodes and may be of the order of 100-150 txV. If a stimulus, such as a light flash, is applied, then a sensory potential is evoked over the area of the brain which processes that signal. For example, the visual potential is evoked over the occipital cortex. However, the potential is very small in amplitude, commonly about 2 ~xV. A sensory evoked potential is, in contrast to the relatively randomly varying nature of the EEG, relatively stable in morphology. It is, therefore, amenable to acquisition by repeated stimulation and averaging of the signal. In the case of the visual evoked potential, which occurs approximately 60 ms after stimulus, the visual stimulus is repetitively applied and the resultant EEG is averaged for a period of, say, 100 ms. Averaging the resultant EEG will, as the number of averages increase, gradually remove the non-stimulus related, randomly varying background EEG and leave the specific sensory evoked potential (thus increasing the signal to noise ratio). Three modalities--visual, somatosensory and auditory--are commonly used for evoking cortical potential during surgery and anaesthesia. The visual stimulus is provided by means of a light flash. This may be applied via light-emitting diodes embedded in swim goggles at a rate of approximately 2 Hz. Higher rates result in the production of more complex wave-forms. Somatosensory evoked potentials are obtained by stimulating a convel~ient nerve, usually the median nerve but alternatively the posterior tibial nerve, with a constant current pulse generator. This is set at 150% of motor threshold, thus ensuring a supramaximal sensory stimulus. The third method of recording cortical potentials is to provide an auditory stimulus, usually clicks provided by headphones. Auditory evoked responses are dealt with in Chapter 7 and are not considered further here. For the measurement of anaesthetic effects, sensory or auditory evoked potentials are generally considered to be more reliable than visual evoked potentials. Flash evoked visual potentials have a relatively high degree of intertrial variability in the
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