Waveguide: an EEG atlas on CD-ROM

British Medical Journal, April 1, 2000 by David Chadwick

Waveguide: an EEG atlas on CD-ROM

Michael W L Chee, Keith H Chiappa,

Lippincott Williams and Wilkins, 76.38 [pounds sterling] ISBN 0 7817 1585 7

Rating: **

A century after the first recordings were made, the electroencephalogram (EEG) remains the most commonly used investigation of cerebral function. It provides considerable temporal resolution of cerebral activity, but remains poor at spatial discrimination, large parts of the cerebral hemispheres being remote from potential recording electrodes. Its interpretation is less than straightforward, and the EEG can reasonably claim to be one of the most misunderstood and abused investigations, a fact that also makes it an extremely dangerous one in untutored hands. Its main clinical use remains in the classification of epilepsy syndromes and seizures, but non-specialists continue to believe, wrongly, that an interictal EEG can prove or disprove a potential diagnosis of epilepsy.

Waveguide is an attempt to apply multimedia presentation to the EEG. The main menu screen allows easy navigation. There are some introductory sections on interpreting EEGs and recognising seizures. The main presentations, however, deal with artefacts, normal rhythms and their variance, abnormal patterns, and seizures. Each of these major sections is divided into subsections, each of which provides an example EEG that can be enlarged. Alongside the EEG is a description of the subject matter, its clinical significance, and suggestions for further reading. The greatest use of multimedia presentation is in the sections on seizures, where EEGs, magnetic resonance images, and brief videotapes of seizures can be viewed.

Unfortunately, some of the presentation is poor, and several opportunities seem to have been missed. Irritatingly, the main menu screen and the rest of the pages can't be expanded to fill the whole of the monitor. The quality of some of the example EEGs is poor, and they have clearly been taken from paper records instead of up to date digital recordings. Relatively few of the EEGs allow you to track the recording through time; instead, you are presented with a single static page. Some of the seizures that are presented are less than typical for their supposed site of origin, and there are no examples of simultaneous video EEG telemetry. The authors have missed the opportunity to put commentary on to continuous video or EEG recordings. An important area of ambulatory EEG is omitted.

I was left feeling somewhat frustrated. The authors seem to have had a good idea but have not exploited the full potential of multimedia presentations. Overall, the treatment is somewhat superficial, and this is certainly no replacement for a major textbook on the subject.

David Chadwick professor of neurology, Walton Centre for Neurology and Neuroscience, Liverpool