Recommendations for the Practice of Clinical Neurophysiology:

Guidelines of the International Federation of Clinical Physiology (EEG Suppl. 52)

Editors: G. Deuschl and A. Eisen
q 1999 International Federation of Clinical Neurophysiology. All rights reserved.
Published by Elsevier Science B.V. 3

Chapter 1.1

The tentwenty electrode system of the International Federation

George H. Klem* (USA), Hans Otto Luders (USA), H.H. Jasper (Canada)
and C. Elger (Germany)

During the First International EEG Congress, 4. Finally, anatomical studies would be carried out
London in 1947, it was recommended that Dr. which would provide additional documentation
Herbert H. Jasper study methods to standardize correlating the electrode placement with the
the placement of electrodes used in EEG (Jasper cortical areas which they record from.
1958). A report with recommendations was to be
presented to the Second International Congress in
Paris in 1949. The electrode placement systems in Technique of measurement
use at various centers were found to be similar, with
only minor differences, although their designations, The measurement technique is based on standard
letters and numbers were entirely different. landmarks of the skull. Namely, the nasion, inion,
Dr. Jasper established some guidelines which and the left and right preauricular points. The
would be established in recommending a specic preauricular points are felt as depressions at the
system to the federation and these are listed below. root of the zygoma, just anterior to the tragus.
The rst measurement is in the anterior-posterior
1. The position of electrodes placed should be based plane through the vertex, taken from the nasion to
on specic measurements of standard skull land-
the inion. This measurement is divided into 5 sepa-
marks. The measurements should be proportional
to the size and shape of the skull.
rate areas (see Fig. 1). The rst mark is placed at
2. Adequate coverage of all parts of the head should 10% of the total measurement and labeled Fp. The
be provided with standard electrode placement. second, third, fourth and fth marks are placed at
3. Electrode designations would be expressed in 20% intervals of the total measurement and labeled
terms of brain areas covered rather than only in F, C, P, and O. Note that the O mark would be
numbers. This would make communications more located at 10% of the measurement above the
meaningful to the non-specialist, as well as inion. The expression Fp, F, C, P and O represent
workers in other laboratories. the fronto polar, frontal, central, parietal and occi-
pital areas, respectively.
Lateral measurement of the central coronal plane
starts at the left preauricular point through the C
* Correspondence to: George H. Klem, Cleveland Clinic
Foundation, EEG Section (S-51), 9500 Euclid Avenue,
vertex mark to the right preauricular point (Fig.
Cleveland, OH 44195 (USA). 2). A mark is placed at 10% of this measurement

Deceased. over the preauricular points and labeled T. The
4

Fig. 1. Lateral view of skull to show methods of measure-

ment from nasion to inion at the midline. Fp is frontal pole
position, F is the frontal line of electrodes, C is the central
line of electrodes, P is the parietal line of electrodes and O is
the occipital line. Percentages indicated represent propor-
tions of the measured distance from the nasion to the inion.
Note that the central line is 50% of this distance. The frontal
pole and occipital electrodes are 10% from the nasion and
inion, respectively. Twice this distance, or 20% separates Fig. 3. Superior view with cross section of skull through the
the other lines of electrodes. temporal line of electrodes illustrating the 1020 system
applied in this direction as described in the text.

expression T represents the temporal area. Marks

are then located at 20% of the lateral measurement position to the midline O position. A mark is made
and labeled left and right C, and the C vertex loca- at 10% of this measurement indicating the left or
tion is crossed. right Fp electrode position. Marks are then made at
A circumferential measurement (Fig. 3) is then 20% of the measurement and are labeled inferior
taken over the temporal lobes from the midline Fp frontal, mid-temporal, and posterior temporal and
left or right occipital (note that the mid-temporal
electrode positions are crossed). The remaining
10% measurement from the left and right occipital
marks would be the midline O position. Variations
of this measurement have been described by Harner
and Sannit (1974).
Antero-posterior measurements are taken from
the left and right Fp position through the lateral C
position to the left and right O position. This
measurement is then divided equally by 25%
marks and labeled lateral F, lateral C, and lateral
P. Anterior coronal measurements are taken from
the left and right inferior frontal position through
the midline F position and divided into 25%
segments, making crosses at the left lateral frontal,
F vertex and right lateral frontal positions. A
Fig. 2. Frontal view of the skull showing the method of
measurement for the central line of electrodes as described
posterior coronal measurement is taken from the
in the text. left posterior temporal mark through the midline
 5

Fig. 4. The lateral view of left and right hemispheres showing all standard electrode positions, omitting intermediate positions
(such as C5 and C6) which are used only for special studies with more closely spaced electrodes. These drawings were made
from a series of X-ray projections with true lateral views. The location of principal ssures was determined by silver clips
placed at operation and by other anatomical studies described in the text. The location of pharyngeal electrodes (Pg1 and Pg2)
was also obtained from X-ray studies with these electrodes in place.

P position and this is also divided into 25% the central sulcus. A numbering system was added
segments and marks are labeled left lateral P, to differentiate between left and right homologous
midline P and right lateral P (Fig. 4). regions, odd numbers for the left hemisphere, Fp1,
These measurements provided for the location of F3, F7, C3, T3, P3, T5, and O1. Even numbers for
19 of the 21 electrodes used in the 1020 electrode the right hemisphere, Fp2, F4, F8, C4, T4, P4, T6,
system (Fig. 5). The remaining two electrodes were and O2. The original recommendation called the F,
placed on the ear lobes and labeled auricular elec- C, and P vertex electrodes F0, C0, and P0, but later
trodes. The electrode positions were named in changed to Fz, Cz, and Pz (z for zero). The numbers
anatomical terms for the cortical areas recorded, selected allowed for additional electrodes to be
with the exception of the ``C'' electrodes which placed in the coronal plane and have suitable desig-
were termed central since they were located over nations (e.g. F2 placed between Fz and F4, and F6

Fig. 5. Frontal superior and posterior views showing all the standard electrode positions as described in the text.
6

Fig. 6. A single plane projection of the head, showing all Fig. 7. Modied combinatorial nomenclature.
standard positions and the location of the rolandic and
sylvian ssures. The outer circle was drawn at the level of International Federation in Paris in 1949. A variety
the nasion and inion. The inner circle represents the
temporal line of electrodes. This diagram provides a useful
of systems have been employed by others to include
stamp for the indication of electrode placements in routine additional electrodes in the AP plane. Recently the
recording. American Electroencephalographic Society (Amer-
ican Electroencephalographic Society 1999a,b)
proposed and adopted Guideline 13: guidelines
placed between F4 and F8). Other additional elec- for standard electrode position nomenclature. This
trodes included pharyngeal and cerebellar elec- provided terminology for the use of additional elec-
trodes which were termed Pg1, Pg2, Cb1 and trodes placed in the sagittal plane. The location of
Cb2, respectively. these electrodes is shown in Fig. 7. Electrode
nomenclature is also described in the latest IFCN
Anatomical studies standards (Nuwer et al. 1998).

Anatomical studies were performed on the heads

of cadavers to determine the cortical areas covered References
by each electrode position. Measurements were
taken and the 1020 system marked on the skulls, American Electroencephalographic Society. Guidelines for stan-
and electrodes were applied. Drill holes were dard electrode position nomenclature, J. Clin. Neurophysiol.,
1991, 8(2): 200202.
placed through the skull and the underlying cortex American Electroencephalographic Society. Guideline 13: guide-
was marked with India ink before removing the lines for standard electrode position nomenclature, J. Clin.
brain for examination. It was concluded that while Neurophysiol., 1994, 11(1): 111113.
Harner, P.F. and Sannit, T. A Review of the International Ten
there was some variability, the two principle
Twenty System of Electrode Placement. Grass Instrument
ssures, central and sylvian, were within ^ 1 cm Company, Quincy, MA, USA, 1974.
of the marks shown on Fig. 6. Jasper, H.H., The tentwenty electrode system of the International
Federation, Electroenceph. clin. Neurophysiol., 1958, 10: 371
375.
Comments Nuwer, M.R., Comi, G., Emerson, R., Fuglsang-Frederiksen, A.,
Guerit, J.-M., Hinrichs, H., Ikeda, A., Luccas, F.J.C. and
Rappelsburger, P. IFCN standards for digital recording of clin-
The 1020 electrode system was adopted for trial ical EEG, Electroenceph. clin. Neurophysiol., 1998, 106: 259
and the meetings of the General Assembly of the 261.