Method of positioning electrodes for central nervous system monitoring

• US 6,950,698 B2
• Filed: 07/02/2003
• Issued: 09/27/2005
• Est. Priority Date: 07/02/2003
• Status: Expired due to Fees

• Current Assignee: Instrumentarium Dental Incorporated (Envista Holdings Corporation)
• Original Assignee: Instrumentarium Dental Incorporated (Envista Holdings Corporation)
• Inventors: Viertio-Oja, Hanna, Sarkela, Mika
• Primary Examiner(s): Nasser, Robert L.
• Assistant Examiner(s): Natnithithadha, Navin
• Application Number:
  US10/612,828
• Publication Number:
  US 20050004489A1
• Time in Patent Office: 818 Days
• Field of Search: 600/544, 600/545
• US Class Current: 600/544
• CPC Class Codes: A61B 5/1106 to assess neuromuscular blockade, e.g. to estimate depth of anaesthesia
• CPC Class Codes: A61B 5/282 Holders for multiple electrodes for introduction into the body A61B5/287
• CPC Class Codes: A61B 5/291 for electroencephalography [EEG]
• CPC Class Codes: A61B 5/296 for electromyography [EMG]
• CPC Class Codes: A61B 5/398 Electrooculography [EOG], e.g. detecting nystagmus; Electroretinography [ERG]
• CPC Class Codes: A61B 5/4821 Determining level or depth of anaesthesia A61B5/1106 takes precedence

Abstract

Method of positioning electrodes in an electrode array, comprising at least five or at least seven electrodes for central nervous system (CNS) monitoring from the forehead of a patient'"'"'s head. The electrodes of the array are optimally located for discriminating EEG, FEMG and EM components from the recorded biopotential signals.

Claims

1. Method of positioning electrodes in an electrode array comprising at least five electrodes for central nervous system (CNS) monitoring from the forehead of a patient'"'"'s head, the method comprising the steps of:

positioning a first electrode above the eyebrows to sense a signal from the frontalis and at least one of the corrugator, procerus, and orbicularis muscles of the patient and to detect phasic and tonic activation of facial muscles expressing painful mimic responses;

positioning a second electrode above the first electrode on the fronto-lateral area of the frontal lobe of the patient and on the same hemisphere as the first electrode;

positioning a third electrode above the eyebrows to sense a signal from the frontalis and at least one of the corrugator, procerus and orbicularis muscles of the patient at the opposite hemisphere when compared to the first electrode and to detect phasic and tonic activation of facial muscles expressing painful mimic responses;

positioning a fourth electrode above the third electrode on the fronto-lateral area of the frontal lobe of the patient and on the same hemisphere as the third electrode; and

positioning a fifth electrode on the patient'"'"'s skin;

wherein the at least five electrodes are arranged to distinguish at least two electroencephalography, frontal electromyography and eye movement signals from each other and assess a level of patient sedation.

2. The method of claim 1 wherein the second electrode is positioned as far as possible from the first electrode and the fourth electrode is positioned as far as possible from the third electrode.

3. The method of claim 2 wherein the areas on which the second, the fourth and the fifth electrode are positioned are hairless areas.

4. The method of claim 1 wherein the fifth electrode is positioned on the area of the patient'"'"'s skin having bone immediately under the skin.

5. The method of claim 4 wherein the areas on which the second, the fourth and the fifth electrode are positioned are hairless areas.

6. The method of claim 1, wherein the first, second, third and fourth electrodes are measuring electrodes and the fifth electrode is a ground electrode.

7. The method of claim 6, wherein frontal electromyography is measured with bipolar connection between the first and the third electrode.

8. The method of claim 6, wherein electroencephalography is measured with bipolar connection between the second and the fourth electrode.

9. The method of claim 6, wherein electroencephalography from one hemisphere is measured between the first and the second electrode, and electroencephalography from the other hemisphere is measured between the third and the fourth electrode.

10. The method of claim 1 wherein the fifth electrode is positioned on the head area of the patient.

11. The method of claim 10 wherein the fifth electrode is positioned at the center of the area defined by the above mentioned four electrodes.

12. Method of positioning electrodes in an electrode array comprising at least five electrodes for central nervous system (CNS) monitoring from the forehead of a patient'"'"'s head, the method comprising the steps of:

positioning a first electrode above the eyebrows to sense a signal from the frontalis and at least one of the corrugator, procerus and orbicularis muscles of the patient and to detect phasic and tonic activation of facial muscles expressing painful mimic responses;

positioning a second electrode to the temple of the patient at the same side of the head as the first electrode;

positioning a third electrode above the eyebrows to sense a sign from the frontalis and at least one of the corrugator, procerus and orbicularis muscles of the patient at the opposite hemisphere when compared to the first electrode and to detect phasic and tonic activation of facial muscles expressing painful mimic responses;

positioning a fourth electrode to the temple of the patient at the same side of the head as the third electrode; and

positioning a fifth electrode on the patient'"'"'s skin,

wherein the at least five electrodes are arranged to measure biopotential signals from both cortical hemispheres for functional comparison to detect non-symmetries between the hemispheres, and to detect eye movements.

13. The method of claim 12 wherein the temple is the area between an eye and an ear.

14. The method of claim 13 wherein the area is at eye level anterior of the ear.

15. The method of claim 12 wherein the fifth electrode is positioned on the area of the patient'"'"'s skin having bone immediately under the skin.

16. The method of claim 15 wherein the fifth electrode is positioned on the head area of the patient.

17. The method of claim 16 wherein the fifth electrode is positioned at the middle area between the first and the third electrode.

18. The method of claim 12 wherein electroencephalography is measured from one hemisphere by using the first and the second electrode, and electroencephalography is measured from the other hemisphere by using the third and the fourth electrode.

19. The method of claim 12, wherein vertical, horizontal and diagonal eye movements are distinguished from each other.

20. Method of positioning electrodes in an electrode array comprising at least seven electrodes for central nervous system (CNS) monitoring from the forehead of a patient'"'"'s head, the method comprising the steps of:

positioning a first electrode above the eyebrows to sense a signal from the frontalis and at least one of the corrugator, procerus and orbicularis muscles of the patient and to detect phasic and tonic activation of facial muscles expressing painful mimic responses;

positioning a second electrode above the first electrode on the fronto-lateral area of the frontal lobe of the patient and on the same hemisphere as the first electrode;

positioning a third electrode above the eyebrows to sense a signal from the frontalis and at least one of the corrugator, procerus and orbicularis muscles of the patient at the opposite hemisphere when compared to the first electrode and detect phasic and tonic activation of facial muscles expressing painful mimic responses;

positioning a fourth electrode above the third electrode on the fronto-lateral area of the frontal lobe of the patient and on the same hemisphere as the third electrode;

positioning a fifth electrode on the patient'"'"'s skin;

positioning a sixth electrode to the temple of the patient at the same side of the head as the first electrode; and

positioning a seventh electrode to the temple of the patient'"'"'s head at the same side of the head as the third electrode,

wherein the at least seven electrodes are arranged to distinguish at least two of electroencephalography, frontal electromyography and eye movement signals from each other, and to measure biopotential signals from both cortical hemispheres for functional comparison to detect non-symmetries between the hemispheres, and to detect eye movements.

21. The method of claim 20 wherein the temple is the area between an eye and an ear.

22. The method of claim 21 wherein the area is at eye level anterior of the ear.

23. The method of claim 20 wherein the fifth electrode is positioned on the area of the patient'"'"'s skin having bone immediately under the skin.

24. The method of claim 23 wherein the fifth electrode is positioned on the head area of the patient.

25. The method of claim 24 wherein the fifth electrode is positioned at the centre area defined by the first, the second, the third and the fourth electrodes.

26. The method of claim 20, wherein vertical, horizontal and diagonal eye movements are distinguished from each other.