MODULE

ELECTRODE
PLACEMENT SYSTEM
FOR SLEEP
ELECTRODE PLACEMENT SYSTEM FOR
SLEEP

OBJECTIVES:
At the end of this module the student must be able to:
• Demonstrate proper measurement of EEG
electrode sites according to the International
10-20 system
• Identify proper placement of EOG electrodes
• Identify proper placement of EMG electrodes
• Identify proper placement of ECG electrodes
LESSON 1: EEG ELECTRODE PLACEMENT

M1 M2

Summary of the International 10-20 Electrode Placement in Sleep

 EEG ELECTRODE PLACEMENT

The EEG records the electrical activity of the brain. The

different brain wave activities identify the specific stage
of sleep.
Correct EEG electrode placement is important to ensure
proper location of electrodes in relation to cortical areas
so that they can be reliably and precisely maintained
from individual to individual.
In order to get the “exact” placement of any EEG
electrode, there must always be a cross-section of two
intersecting marks.
The next slides will be a step by step guide on how the
EEG electrodes are attached on the scalp of the patient
using the International 10-20 Electrode Placement
 EEG ELECTRODE PLACEMENT

PROCEDURE:
1. Take measuring tape and
use the centimeter side.
Start from the "0" mark
(cm side).
Measure from the Nasion
(bridge of the nose) to the
Inion (occipital
pretuberance - if you run
your finger up the back of
the neck of the skull, you
will encounter a
depression with the ridge
of the protruding inion just
above it).
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

Mark the Nasion and

Inion. (As a rule of the
thumb, whichever
direction the numbers are
facing on the measuring
tape is the direction you
should make your
marking). Get your total
(for teaching purposes,
let us say it is 36 cm).
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

2. Mark 50% of your total

(i.e. 18 cm).
This is your first mark of
CZ.
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

3. Mark 10% up from the

nasion and 10% up from FPZ

the inion. (i.e. 3.6 cm)

This is your first mark of
FPZ and OZ.

oz
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

4. Mark 20% up from either

FPZ
the first mark of FPZ or
CZ. (i.e. 7.2 cm)
This will be your first
mark of FZ.
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)
5. Measure from pre-
auricular point to pre-
auricular point. Have the
patient open his mouth
slightly. Lightly run your
finger up and down just
anterior to the ear; the
indentation above the
zygomatic notch is easily
identified. Obtain your
total. (i.e. 38cm)
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

Mark half of your total

(this number should
intersect with your first
50% mark). (ex. 19 cm)
This is your true CZ
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

6. Mark 10% up from each

pre-auricular point. (ex.
3.8 cm) These are your
first marks of T3, and T4.
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

7. Measure from your first

mark of T3 to your CZ
and obtain your total. (ex.
15 cm)

Mark half of your total.

(ex. 7.5 cm)
This is your first mark of
C3.
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

8. Measure from your first

mark of T4 to your CZ
and obtain your total. (ex.
15 cm)

Mark half of your total.

(ex. 7.5 cm)
This is your first mark of
C4.
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

9. Draw a cross-section on
FPZ
your first mark of FPZ.
This is your true FPZ
mark.
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

10. Encircle the measuring

tape all across your 10%
mark; obtaining your
circumference total. (ex.
56 cm)
Mark half of your total.
(ex. 28 cm)
This will be your true
mark of OZ.
OZ
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

11. Mark 5% (ex. 2.8 cm) of

the half to the left and
right of OZ.
These will be your true
marks of O1 and O2
respectively.
OZ
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

12. Mark 5% (ex. 2.8 cm) to

FPZ
the left and right of FPZ.
These will be your true
marks of FP1 and FP2
respectively.
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

13. Mark 10% further down

from FP1 and FP2.
(ex. 5.6 cm)
These will be your marks
for F7 and F8
respectively.
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

14. Measure from F7 to F8

and obtain your total. (ex.
32 cm)

Mark half of your total.

(ex. 16 cm).
Where your first mark of
FZ and this second mark
of FZ intersect is your
true mark of FZ.
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

15. Measure from F7 to FZ.

Obtain your total. (ex. 16
cm)

Mark half. (ex. 8 cm)

This will be your first
mark of F3.
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

16. Measure from F8 to FZ.

Obtain your total. (ex. 16
cm)

Mark half. (ex. 8 cm)

This will be your first
mark of F4.
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

17. Measure 20% from FP1

to F3. (ex. 7 cm)
This will be your final
mark of F3.
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

18. Measure 20% from FP2

to F4. (ex 7 cm)
This will be your final
mark of F4.
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

19. Measure from FP1 to

your first mark of C3 to
your O1. Obtain your
total. (ex. 28 cm)

Mark half of your total.

(ex 19 cm)
Where your first and
second marks intersect
will be your true
placement of C3
 EEG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

20. Measure from FP2 to

your first mark of C4 to
your O2. Obtain your
total. (ex. 28 cm)

Mark half of your total.

(ex 19 cm)
Where your first and
second marks intersect
will be your true
placement of C4
 EEG ELECTRODE PLACEMENT

OVERVIEW:

3) Measure Nasion to Inion. Get total.

4) Mark 50% from the total. This is your initial mark for
CZ.
5) Mark 10% up from the Nasion and Inion. Initial mark of
FPZ and OZ.
6) Mark 20% from FPZ or CZ. Initial mark of FZ.
7) Measure from Pre-auricular point to pre-auricular point.
Get the total. Mark 50%. Where line will intersect with
initial CZ, this is the FINAL mark of CZ
 EEG ELECTRODE PLACEMENT

OVERVIEW: (cont’d)

6) Mark 10% up from each pre-auricular point. This is your

T3, T4
7) Measure from first mark of T3 to your CZ. Obtain total.
Mark half. This is your first mark of C3.
8) Measure from first mark of T4 to CZ. Obtain total. Mark
half. First mark of C4.
9) Draw a cross-section across FPZ. This is your FINAL
FPZ mark.
 EEG ELECTRODE PLACEMENT

OVERVIEW: (cont’d)

10) Measure entire circumference of head, going all across

10% marks, starting from FPZ. Get total. Mark half.
TRUE mark of OZ.
11) Mark 5% of the half to the left and right of OZ.
These will be your TRUE marks of O1 and O2.
12) Mark 5% of the half to the left and right of FPZ. True
marks of FP1 and FP2.
13) Mark 10% further down from FP1 and FP2.
Your marks for F7 and F8.
 EEG ELECTRODE PLACEMENT

OVERVIEW: (cont’d)

14) Measure from F7 to F8 and obtain your total. Mark half.

Where your first and second marks of FZ intersect is
your FINAL mark of FZ.
15) Measure from F7 to FZ. Obtain total. Mark half. This
will be your first mark of F3.
16) Measure from F8 to FZ. Obtain total. Mark half. First
mark of F4.
17) Measure 20% from FP1 to F3. This will be your final
mark of F3.
 EEG ELECTRODE PLACEMENT

OVERVIEW: (cont’d)

18) Measure 20% from FP2 to F4. Final mark of F4.

19) Measure from FP1 to first mark of C3 to O1. Obtain
total. Mark half. Where your first and second marks
intersect will be your TRUE C3.
20) Measure from FP2 to first mark of C4 to O2. Obtain
total. Mark half. Where first and second marks intersect
will be your true placement of C4.
 EEG ELECTRODE PLACEMENT

This concludes the “Modified” 10-20 Electrode

Placement System for Sleep.

Next is the proper placement of EOG electrodes.

 EOG ELECTRODE PLACEMENT

Electrodes are placed on

each eye to determine
electrical activity caused
by eye movements

PROCEDURE:

On the Right, the EOG

electrode is placed on the
upper- outer edge of the
right eye. (usually 1cm
out and 1 cm up from the
outer canthus of the eye)
 EOG ELECTRODE PLACEMENT

PROCEDURE:

On the Left, the EOG

electrode is placed on the
lower-outer edge of the
left eye. (usually 1cm out
and 1 cm down from the
outer canthus of the eye)
Both are referenced to
the contralateral mastoid
site (M1, M2)
 EOG ELECTRODE PLACEMENT

This concludes the proper placement of Right and Left

EOG electrodes.

Next is the proper placement of the Chin, Leg & Arm

EMG electrodes.
 EMG ELECTRODE PLACEMENT

The EMG records the electrical activity of the muscles on

the chin as the face twitches, the teeth grinds and the
muscle relaxes on REM sleep. Electrodes are also
placed on the limb, such as leg and/or arm, to monitor
excessive amount of movements during sleep.
 EMG ELECTRODE PLACEMENT

PROCEDURE:

The Chin EMG electrode

is placed on the mentalis
and submentalis muscle

Mentalis Submentalis
 EMG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

• The Leg EMG electrode

is placed on the anterior
tibialis muscle, 2-4 cm
apart vertically.
To locate the anterior Anterior Tibialis
tibialis muscle, palpate
the shin as the patient
repetitively points and
flexes the foot or toes.
The optimal electrode
placement area is below
the knee, anywhere from
midpoint of the shinbone
to the outer area of the
upper shin.
 EMG ELECTRODE PLACEMENT

PROCEDURE: (cont’d)

• The Arm EMG electrode

is placed on the forearm
on the extensor digitorum
muscle.
To locate it, have the
patient extend the
forearm with palm
downward. Then, feel the
upper surface of the
forearm as the patient
bends the wrist up and
down.
 EMG ELECTRODE PLACEMENT

This concludes the proper placement of EMG electrode

on the chin, leg and arm.

Next is the proper placement of ECG electrodes

 ECG ELECTRODE PLACEMENT

ECG records the

electrical activity of the clavicle
heart, such as the rate
and the rhythm. Mid-
Right
ECG clavicular
PROCEDURE: placement line (left)

• Electrodes are placed just

beneath the right clavicle 5th
(collar bone) and at the intercostal
space
midclavicular line on the
left (slightly lower than
the right) and the fifth
intercostal space
 ECG ELECTRODE PLACEMENT

This concludes the ECG placement

 ELECTRODE PLACEMENT SYSTEM FOR
SLEEP

On this module you have learned to identify the proper

placement of the:
EEG
EOG
EMG and
ECG leads