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Clinical Neurophysiology,9780195140804
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Clinical Neurophysiology


Author(s): Jasper R. Daube
ISBN10:  019514080X
ISBN13:  9780195140804
Format:  Hardcover
Pub. Date:  9/19/2002
Publisher(s): Oxford University Press, USA

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SummaryTable of Contents
This text is a fully integrated summary of all aspects of clinical neurophysiology. It is written by nationally recognized experts who work together at Mayo Clinic. All the authors are heavily involved in the teaching of clinical neurophysiology to residents in neurology, neurosurgery and physical medicine, and to post-residency fellows in EEG, EMG, autonomic disorder, sleep disorders, peripheral nerve diseases, and muscle diseases.
The first section is a review of the basics of clinical neurophysiology. The second considers the assessment of disease by anatomical system. The third explains how clinical neurophysiologic techniques are used in the clinical assessment of diseases of the nervous system.
This thoroughly revised Second Edition includes new approaches and a new chapter on the clinical neurophysiology of pain. The clinical problems in which each of the clinical neurophysiologic approaches can add to the diagnosis and management of neurologic disease are detailed, especially the assessment of clinical symptom complexes with electroencephalography (EEG). The discussions of pediatric EEG disorders, ambulatory EEG, new equipment and digital analyses, magneto-EEG, electromyographic (EMG) techniques, motor unit number estimates, myoclonus on surface EMG, segmental sympathetic reflex, and postural normotension have been expanded. Chapters on EMG quantified and single fiber EMG have been reorganized, and major revisions have been made in the discussion of sensory potentials, somatosensory evoked potentials, acoustic reflex testing, cardiovagal function, physiologic testing of sleep, and assessment of sleep disorders. New approaches are discussed in each of the four chapters on monitoring neural function during surgery, particularly with motor evoked potentials.
Contribution xxiii
SECTION 1. ANALYSIS OF ELECTROPHYSIOLOGIC WAVEFORMS
Electricity and Electronics for Clinical Neurophysiology
3(14)
Terrence D. Lagerlund
Basic Principles and Definitions in Electricity
3(2)
Circuit Analysis
5(2)
Resistive-Capacitive and Resistive-Inductive Circuits
7(1)
Circuits Containing Inductors and Capacitors
8(4)
Filter Circuits
12(1)
Transistors and Amplifiers
13(4)
Electric Safety in the Laboratory and Hospital
17(11)
Terrence D. Lagerlund
Electric Power Distribution Systems
17(1)
Electric Shock
17(3)
Leakage Current
20(4)
Electric Safety Principles and Implementation
24(4)
Volume Conduction
28(13)
Terrence D. Lagerlund
Principles
28(2)
Electric Properties of Volume Conductors
30(1)
Calculating Potentials in Infinite Homogeneous Media
30(4)
Potentials in Nonhomogeneous Media
34(2)
Applications of Volume Conduction Principles
36(5)
Digital Signal Processing
41(12)
Terrence D. Lagerlund
Digital, Computers in Clinical Neurophysiology
41(3)
Digitization
44(3)
Common Uses of Digital Processing
47(1)
Averaging
48(1)
Digital Filtering
49(1)
Time and Frequency Domain Analysis
50(3)
Electrophysiologic Generators in Clinical Neurophysiology
53(10)
Terrence D. Lagerlund
Physiologic Generators
53(5)
Structural Generators
58(5)
Classification of Waveform Characteristics
63(6)
Jasper R. Daube
Continuous Waveforms
63(3)
Event Recording
66(3)
Alteration of Waveforms and Artifacts
69(8)
Jasper R. Daube
Physiologic Alteration of Waveforms
69(3)
Artifactual Waveforms
72(5)
SECTION 2. ELECTROPHYSIOLOGIC ASSESSMENT OF NEURAL FUNCTION
Part A. Cortical Function
Electroencephalography: General Principles and Adult Electroencephalograms
77(31)
Donald W. Klass
Barbara F. Westmoreland
Clinical Usefulness of Electroencephalography
77(1)
Display of Electroencephalography Activity
78(2)
Activation Procedures
80(2)
Artifacts
82(1)
Normal, Electroencephalographic Activity of Adults
82(5)
Benign Variants
87(3)
Pathologic Activity
90(4)
Electroencephalographic Manifestations of Focal Intracranial Lesions
94(6)
Electroencephalographic Manifestations of Diffuse Encephalopathies
100(4)
Evaluation for Suspected Brain Death
104(4)
Electroencephalography: Electroencephalograms of Neonates, Infants, and Children
108(16)
Barbara F. Westmoreland
Neonatal Electroencephalographic Patterns
108(5)
Developmental Changes During Infancy, Childhood, and Adolescence
113(2)
Benign Variants in Children
115(1)
Abnormalities
116(8)
Ambulatory Electroencephalography
124(5)
Jeffrey R. Buchhalter
Indications
124(1)
Technology
125(1)
Clinical Applications
126(3)
Prolonged Video Electroencephalography
129(8)
Cheolsu Shin
Equipment
130(1)
Clinical Application
131(6)
Electroencephalographic Special Studies
137(9)
Terrence D. Lagerlund
Quantitative Methods of Electroencephalographic Analysis
137(7)
Magnetoencephalography
144(2)
Electroencephalographic Recordings for Epilepsy Surgery
146(15)
Gregory D. Cascino
Candidates for Epilepsy Surgery
147(1)
Extracranial Electroencephalography in Partial Epilepsy
148(3)
Chronic Intracranial Monitoring
151(6)
Electrocorticography in Epilepsy Surgery
157(4)
Movement-Related Potentials and Event-Related Potentials
161(8)
Joseph E. Matsumoto
Movement-Related Cortical Potentials
161(3)
Event-Related Potentials
164(5)
Part B. Sensory Pathways
Nerve Action Potentials
169(12)
Eric J. Sorenson
Clinical Importance
169(3)
Planning the Study
172(1)
Radiculopathy
172(1)
Plexopathy
173(1)
Common Mononeuropathies
173(2)
Technical Factors
175(1)
Human Factors
176(1)
Methods
177(1)
Measurements
177(4)
Somatosensory Evoked Potentials
181(23)
J. Clarke Stevens
Methods
182(8)
Somatosensory Evoked Potential Interpretation
190(1)
Clinical Applications
191(13)
Brain Stem Auditory Evoked Potentials in Central Disorders
204(10)
John N. Caviness
Auditory Anatomy and Physiology
205(1)
Auditory Evoked Potentials in Normal Subjects
205(2)
Methods
207(1)
Use of Brain Stem Auditory Evoked Potentials in Clinical Problem Solving
207(7)
Audiogram, Acoustic Reflexes, and Evoked Otoacoustic Emissions
214(8)
Christopher D. Bauch
Wayne O. Olsen
Audiogram
215(1)
Acoustic Reflex
216(2)
Evoked Otoacoustic Emissions
218(4)
Brain Stem Auditory Evoked Potentials in Peripheral Acoustic Disorders
222(5)
Christopher D. Bauch
Stimuli
222(1)
Interpretation
223(1)
Electrodes
224(1)
Applications
224(3)
Visual Evoked Potentials
227(10)
John N. Caviness
Visual System Anatomy and Physiology
227(1)
Visual Evoked Potentials in Normal Subjects
228(1)
Methods
229(1)
General Principles of Interpretation of Visual Evoked Potentials
230(1)
Use of Visual Evoked Potentials in Clinical Problem Solving
230(1)
Localization of Visual System Lesions
231(6)
Part C. Motor Pathways
Compound Muscle Action Potentials
237(31)
Jasper R. Daube
Clinical Application
238(1)
Recording Compound Muscle Action Potentials
238(2)
Stimulation
240(2)
Compound Muscle Action Potential Measurements
242(3)
F Waves
245(4)
Physiologic Variables
249(1)
Compound Muscle Action Potential Changes in Disease
250(1)
Findings in Peripheral Nerve Disorders
251(17)
Assessing the Neuromuscular Junction with Repetitive Stimulation Studies
268(14)
Robert C. Hermann, Jr.
Anatomy and Physiology of the Neuromuscular Junction
268(2)
Technique
270(6)
Criteria of Abnormality
276(1)
Rapid Rates of Stimulation
276(1)
Selection of Nerve--Muscle Combinations
276(2)
Clinical Correlations
278(4)
Motor Evoked Potentials
282(11)
Jasper R. Daube
Motor Evoked Potential Stimulation
282(3)
Motor Evoked Potential Recording
285(1)
Motor Evoked Potential Variables
285(1)
Applications
286(7)
Part D. Assessing the Motor Unit
Assessing the Motor Unit with Needle Electromyography
293(31)
Jasper R. Daube
Knowledge Base of Needle Electromyography
294(1)
Conducting the Needle Examination
294(1)
Needle Examination Techniques
295(2)
Electromyographic Analysis
297(2)
Origin of Electromyographic Potentials
299(1)
Normal Electromyographic Activity
299(2)
Recruitment
301(4)
Signal Analysis
305(2)
Abnormal Electric Activity
307(17)
Quantitative Electromyography
324(19)
Robert C. Hermann, Jr.
Characteristics of the Motor Unit Potential
325(1)
Characteristics of the Recording Equipment
326(2)
Properties of Motor Unit Potentials with Standard Electrodes
328(2)
Motor Unit Potential Complexity (Phases, Turns, Crossings)
330(2)
Properties of Motor Unit Potentials Measurable Only with Special Electrodes
332(1)
Properties of Interference Pattern
333(1)
Manual, Analysis of Single Motor Unit Potentials
334(1)
Computer-Assisted Quantitative Analysis of Motor Unit Potentials
335(2)
Automated Methods of Analysis of Motor Unit Potentials
337(1)
Decomposition of the Interference Pattern into Constituent Motor Unit Potentials
337(2)
Turns and Amplitude Analysis of the Interference Pattern
339(1)
Power-Spectrum Analysis
340(3)
Single Fiber Electromyography
343(15)
C. Michel Harper, Jr.
Technique
345(4)
Pitfalls of Single Fiber Electromyography
349(4)
Clinical Applications of Single Fiber Electromyography
353(5)
Estimating the Number of Motor Units in a Muscle
358(17)
Jasper R. Daube
Motor Unit Number Estimate by Standard Electromyography
359(1)
Motor Unit Number Estimate by Standard Nerve Conduction Studies
360(1)
Quantitative Motor Unit Number Estimate
361(7)
Clinical Applications
368(7)
Part E. Reflexes And Central Motor Control
H Reflexes
375(7)
Kathryn A. Stolp-Smith
Physiologic Basis
375(2)
Technique
377(1)
Pediatric H Reflexes
378(1)
Clinical Application
379(3)
Cranial Reflexes
382(12)
Raymond G. Auger
J. Clarke Stevens
Blink Reflex
382(7)
Jaw Jerk (Masseter Reflex)
389(2)
Masseter Inhibitory Reflex
391(3)
Long Latency Reflexes and the Silent Period
394(5)
Joseph Y. Matsumoto
Long Latency Reflexes
394(2)
The Silent Period
396(3)
Surface Electromyographic Studies of Movement Disorders
399(14)
James H. Bower
Joseph Y. Matsumoto
Techniques
400(1)
Normal Patterns
401(1)
Tremor
402(3)
Myoclonus
405(4)
Dystonia
409(2)
Tics, Chorea, and Athetosis
411(1)
Surface Electromyographic Study of Voluntary Movement Disorders
411(2)
Vertigo and Balance
413(24)
Robert H. Brey
Office Procedures and History Taking
414(1)
Physical Examination of the Vestibular System
415(5)
Laboratory Examination: Electronystagmography Test Battery
420(7)
Otolith Organ Testing
427(1)
Superior Semicircular Canal Dehiscence
427(1)
Computerized Rotary Chair Test (Harmonic Acceleration Testing)
428(2)
Computerized Dynamic Posturography
430(3)
Vestibular Rehabilitation
433(4)
Part F. Autonomic Function
Clinical Physiology of the Autonomic Nervous System
437(8)
Eduardo E. Benarroch
Symptoms and Diseases
437(1)
General Organization of the Autonomic System
438(1)
Sympathetic Function
439(1)
Sympathetic Innervation of the Skin
440(1)
Muscle Sympathetic Activity
440(1)
Autonomic Control of Heart Rate
441(1)
Cardiovascular Reflexes
441(1)
Maintenance of Postural Normotension
442(3)
Quantitative Sudomotor Axon Reflex Test and Related Tests
445(6)
Phillip A. Low
Laboratory Evaluation of Autonomic Function
445(1)
Quantitative Sudomotor Axon Reflex Test
445(6)
Adrenergic Function
451(7)
Phillip A. Low
Skin Vasomotor Reflexes
451(7)
Thermoregulatory Sweat Test
458(9)
Robert D. Fealey
Role of Thermoregulatory Sweat Testing: Clinical Syndromes and Problems Evaluated
458(1)
Method
459(3)
Normal Thermoregulatory Sweat Distributions
462(1)
Reporting Results
463(1)
Difficulties and Pitfalls in Interpretation
464(3)
Cardiovagal and Other Reflexes
467(10)
Eduardo E. Benarroch
Phillip A. Low
Heart Rate Response to Deep Breathing
467(2)
Heart Rate Response to Standing
469(1)
Other Tests of Cardiovagal Function
469(1)
Power Spectrum Analysis
470(1)
The Valsalva Maneuver
470(4)
Other Tests of Autonomic Function
474(3)
Electrophysiology of Pain
477(16)
Rose M. Dotson
Quantitative Sensory Test
477(4)
Autonomic Tests
481(2)
Microneurography
483(1)
Laser Evoked Potentials
484(9)
Part G. Sleep and Consciousness
Physiologic Assessment of Sleep
493(20)
Peter J. Hauri
Cameron D. Harris
Michael H. Silber
Definitions
493(4)
Evaluation of Sleep
497(7)
Assessing Respiration during Sleep
504(6)
Assessing Periodic Limb Movements
510(1)
Assessing Other Physiologic Variables
511(2)
Assessing Sleep Disorders
513(10)
Peter J. Hauri
Cameron D. Harris
Michael H. Silber
Indications for Polysomnography
513(1)
Partial Evaluations
514(1)
Performance of a Sleep Study
515(1)
Disorders of Excessive Daytime Somnolence
516(1)
Parasomnias
517(6)
Part H. Intraoperative Monitoring
Cerebral Function Monitoring
523(9)
Elson L. So
Frank W. Sharbrough
Technical Factors in Intraoperative Electroencephalographic Monitoring
523(4)
Symmetrical Electroencephalographic Patterns During Anesthesia
527(1)
Preoperative Focal Abnormalities
527(1)
Focal Electroencephalographic Changes During Carotid Endarterectomy
528(1)
Electroencephalography and Other Monitoring Techniques in Relation to Surgical Strategy During Carotid Endarterectomy
529(1)
Electroencephalographic Monitoring During Cardiac Surgery
530(2)
Brain Stem and Cranial Nerve Monitoring
532(7)
C. Michel Harper, Jr.
Methods
532(3)
Applications
535(4)
Spinal Cord Monitoring
539(16)
Jasper R. Daube
Applications
539(1)
Monitoring Methods
540(6)
Electromyographic and Nerve Conduction Studies
546(1)
Types of Surgery
547(5)
Primary Vascular Disease
552(3)
Peripheral Nervous System Monitoring
555(10)
C. Michel Harper, Jr.
Methods
555(1)
Applications
556(9)
SECTION 3. APPLICATIONS OF CLINICAL NEUROPHYSIOLOGY: ASSESSING SYMPTOM COMPLEXES AND DISEASE ENTITIES
Application of Clinical Neurophysiology: Assessing Symptom Complexes
565(34)
Jasper X. Daube
Elson L. So
Clinical Neurophysiology in the Assessment of Disease
566(1)
When Clinical Neurophysiology Can Help
567(1)
Symptom Complexes and Neural Systems
568(2)
Localization of Disease
570(1)
Identifying Disease Types
571(1)
Prognosis
572(3)
Assessing Clinical Disorders: Assessment with Electroencephalography
575(8)
Assessing Clinical Disorders: Assessment with Electromyography and Nerve Conduction Studies
583(16)
Glossary of Electrophysiologic Terms 599(30)
Index 629

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