Standard Electroencephalography in Clinical Psychiatry A Practical Handbook

by Boutros, Nash N.; Galderisi, Silvana; Pogarell, Oliver; Riggio, Silvana

• ISBN13: 9780470747827
• ISBN10: 047074782X
• Edition: 1st
• Format: Paperback
• Copyright: 2011-04-25
• Publisher: Wiley

Summary

This book provides a concise overview of the possible clinical applications of standard EEG in clinical psychiatry. It starts with a short history then describes the physiologic basis of the EEG signal. The material is clearly presented throughout, with figures, tables with summaries of relevant findings, flow diagrams for diagnostic work-up, boxes with learning points, and short lists of key references.

Author Biography

Nash Boutros, MD, is Professor of Psychiatry and Neurology, Director of the Divisions of Clinical Cognitive Neuroscience, Neuropsychiatry and Clinical Electrophysiology, and Associate Chair for Research of the Department of Psychiatry and Behavioral Neurosciences at Wayne State University School of Medicine. He is the local Director of an NIMH-funded multicenter study for the identification of the endophenotypes of schizophrenia and bipolar disorders. Dr. Boutros is internationally renowned for his research on the electrophysiological correlates of psychiatric disorders, particularly schizophrenia, the relationship of isolated epileptic activity to psychiatric disorders and the development of methodology to facilitate the translation of interesting biological findings to clinically useful tests. In recent years, his research has focused on developing an animal model for isolated epileptic spike discharges and examining the behavioral correlates of such events. This effort is motivated by the not uncommon human problem of having isolated epileptic discharges and behavioral aberrations in the absence of frank epilepsy. Dr. Boutros is a senior fellow of the American Psychiatric Association and fellow of the American Neuropsychiatric Association and one of the founders of the EEG and Clinical Neuroscience Society (ECNS). He is Editor-in-Chief of the International Psychiatry and Behavioral Neuroscience Year Book which selects papers published from all non-English languages where science is published. Dr. Boutros has written over 170 peer-reviewed journal articles and chapters, as well as The Brain and Behavior: An Introduction to Behavioral Neuroanatomy.

Silvana Galderisi is Professor of Psychiatry and Director of the training school in Psychiatry at the University of Naples SUN. She is Director of the Emergency Unit of the Department of Mental Health of the same University. She is also Chairperson of the WPA Psychophysiology Section, President of the EEG & Clinical Neuroscience Society, co-Chair of the International Society for Brain Electromagnetic Topography. She has authored more than 150 publications, in national and international journals and books, and is member of the Editorial Board of Psychiatry Research Neuroimaging, European Journal of Psychiatry, Brain Topography, International Journal of Psychophysiology, Neuropsychobiology,Clinical EEG and Neuroscience and European Psychiatric Review. Her main contribution to the international literature in the field of Electrophysiology includes EEG and ERP abnormalities of major psychiatric disorders, especially schizophrenia, and the identification of early drug-induced EEG changes predictive of treatment response in schizophrenia patients.

Oliver Pogarell MD, PhD, is neurologist, psychiatrist and Head of the Dept. of Clinical Neurophysiology and Functional Neuroimaging at the Clinic for Psychiatry and Psychotherapy, University of Munich, Germany. He is member of national and international neurophysiology societies and host of annual scientific training courses in clinical neurophysiology in Germany. His lab offers the entire spectrum of neurophysiological diagnostics for the Dept. of Psychiatry with about 3500 EEG recordings per year. In addition to visual EEGs within the clinical routine, he has expertise in quantitative EEG techniques including dipole source analysis or low resolution electromagnetic tomography both in resting state and under stimulation with cognitive paradigms. His research has focused on neurophysiology as well as functional and molecular neuroimaging in neuropsychiatric disorders.

Silvana Riggio, MD, Professor of Neurology and Psychiatry at the Mount Sinai School of Medicine (MSSM). Dr.Riggio trained in Neurology at Georgetown University. She is fellowship trained in neuro-electrophysiology at John Hopkins and in Clinical Epilepsy at the Medical College of Pennsylvania (MCP). She served as the Co-Director of the Mid- Epilepsy Center from 1989 – 1991 and the Director of the Epilepsy Program at Mayo Clinic Jacksonville, 1992-1995.  Dr. Riggio developed a strong interest in disorders of the frontal lobe and their behavioral manifestations. She trained in Psychiatry at Cornell Weill Medical Center after which she came to Mount Sinai in 1998. She has lectured nationally and internationally and has participated on National Committees related to traumatic brain injury (TBI). Dr. Riggio participated on the ACEP-CDC guidelines task force on mild TBI which was published in December 2008 and is currently finishing a CDC project on discharge instructions for patients with mild TBI. Dr. Riggio has expertise in understanding the interface between neurologic, behavioral, and physical health. She has authored over 50 articles and book chapters and has edited 8 books and journal supplements. Most recently she edited a theme issue of the Mount Sinai Journal of Medicine, "Traumatic Brain Injury, from Bench to Bedside to Home". She is currently editing an issue for the Psychiatric Clinics of North America on Traumatic Brain Injury. Dr. Riggio is a member of the advisory board for the Indian Head Injury Foundation and also for the Foundation for Education and Research in Neurologic Emergencies (FERNE).She has been the primary investigator or co-investigator on 22 grants. She has been recognized for excellence in teaching having received many awards including the MSSM Institute of Medical Education Teaching Achievement Award; she was honored the title of Commendatore OSSI by the Italian government in 2009. Dr. Riggio is the Medical Director for the NFL Neurological Care Program at Mount Sinai which was established in 2010.

Table of Contents

List of Contributors	p. ix
Preface	p. xi
Historical Review of Electroencephalography in Psychiatry	p. 1
Introduction	p. 1
The early pre-clinical era	p. 1
Early history of human electroencephalography	p. 3
Electroencephalography in psychiatry today	p. 5
References	p. 5
Physiologic Basis of the EEG Signal	p. 7
Membrane potentials	p. 7
Excitatory and inhibitory postsynaptic potentials	p. 8
Nonsynaptic intercellular events contributing to the EEG signal	p. 8
Factors determining polarity and other characteristics of the surface EEG waveforms	p. 8
Brain structures involved in the genesis of EEG rhythms	p. 10
References	p. 12
EEG Recording and Analysis	p. 13
Techniques and technical background	p. 13
References	p. 30
Normal EEG Patterns and Waveforms	p. 33
Introduction	p. 33
Normal EEG patterns in the waking aduLt	p. 35
References	p. 54
Abnormal Patterns	p. 59
Introduction	p. 59
Detection of artefacts	p. 60
Abnormal patterns	p. 60
Focal alterations	p. 68
References	p. 76
The Role of EEG in the Diagnostic Work Up in Psychiatry: Nonconvulsive Status Epilepticus, Frontal Lobe Seizures, Non-Epileptic Seizures	p. 77
Nonconvulsive status	p. 77
Psychogenic non-epileptic seizures	p. 81
Frontal lobe seizures	p. 85
References	p. 88
EEG in Childhood Psychiatric Disorders	p. 91
Introduction	p. 91
Attention deficit disorder	p. 92
Autistic spectrum disorders	p. 100
References	p. 108
EEG in Psychoses, Mood Disorders and Catatonia	p. 113
Introduction	p. 113
EEG in psychoses	p. 114
EEG in mood disorders	p. 123
EEG findings in catatonia	p. 124
References	p. 129
Standard EEG in Personality and Anxiety Disorders	p. 133
Introduction	p. 133
EEG in aggression and impulse dyscontrol	p. 133
Panic attacks	p. 138
Borderline personality disorder	p. 142
References	p. 144
EEG in Delirium and Dementia	p. 147
Introduction: Epidemiology of delirium and dementia	p. 147
Clinical diagnosis in delirium	p. 149
EEG work up in delirium	p. 150
Metabolic causes of delirium	p. 151
Infectious causes of delirium	p. 154
Clinical diagnosis and EEG work up in dementia	p. 155
Conclusion	p. 158
References	p. 159
Effects of Psychotropic Drugs on EEG	p. 163
Introduction	p. 163
The role of EEG assessment of drug-induced CNS toxicity in psychiatric patients	p. 163
Antipsychotic drugs	p. 164
Lithium	p. 166
Other mood stabilisers	p. 167
Anxiolytics	p. 168
Antidepressants	p. 169
Recreational drugs	p. 169
Case vignette	p. 170
References	p. 171
Certification and Training in EEG and Clinical Neurophysiology	p. 173
Clinical neurophysiology board certification	p. 173
Index	p. 179
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