Rhythmic artifact of physiotherapy in intensive care unit EEG recordings

Intensive care unit EEG recordings are often contaminated by artifacts that are unseen elsewhere and are usually not documented. One is the rhythmic artifact of physiotherapy (RAP), which can follow the frequency of chest percussion or vibration with either fundamental or harmonic sinusoidal wave forms, affecting single or multiple channels. The occipital electrodes are the most commonly affected, but others can be involved separately or in combination. RAP can easily be mistaken for cerebrally originating rhythms, including seizures. RAP is most easily detected by examining the ECG channel, which usually captures the artifact, but video EEG provides another means, at least for chest percussion.