Atlas of EEG Patterns (c) 2015 Wolters Kluwer. All Rights Reserved. LWBK1139-FM_i-x.indd 1 1/3/13 3:00 PM Atlas of EEG Patterns Second Edition John M. Stern, MD Professor of Neurology David Geffen School of Medicine University of California Los Angeles, California Jerome Engel, Jr, MD, PhD Consulting Editor, 1st edition (c) 2015 Wolters Kluwer. All Rights Reserved. LWBK1139-FM_i-x.indd 3 1/3/13 3:00 PM Acquisitions Editor: Julie Goolsby Product Manager: Tom Gibbons Vendor Manager: Bridgett Dougherty Senior Manufacturing Manager: Benjamin Rivera Marketing Manager: Alexander Burns Design Coordinator: Joan Wendt Production Service: Aptara, Inc. © 2013 by LIPPINCOTT WILLIAMS & WILKINS, a WOLTERS KLUWER business Two Commerce Square 2001 Market Street Philadelphia, PA 19103 USA LWW.com © 2005 by Lippincott Williams & Wilkins. All rights reserved. This book is protected by copyright. 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It is the responsibil- ity of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: at LWW.com. Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to 6 pm, EST. 10 9 8 7 6 5 4 3 2 1 (c) 2015 Wolters Kluwer. All Rights Reserved. LWBK1139-FM_i-x.indd 4 1/3/13 3:00 PM For Jackie (c) 2015 Wolters Kluwer. All Rights Reserved. LWBK1139-FM_i-x.indd 5 1/3/13 3:00 PM Acknowledgments I am thankful to many individuals for their contributions to this book. UCLA epilepsy and clinical neurophysiology fellows over the past 10 years have helped identify the EEGs in this edition and the first edition. Their enthusiastic efforts are much appreciated. Christopher Carnabatu and Kirk Shattuck deserve special appreciation for their technical assistance with the figures. Pete Engel’s contributions to the first edition were substantial and I am particularly thankful for his support. Most of all, I am grateful to the support of Jackie, Peter, and Joel Stern. By sharing me with this project, they made this book possible. vii (c) 2015 Wolters Kluwer. All Rights Reserved. LWBK1139-FM_i-x.indd 7 1/3/13 3:00 PM Contents Section I | Introduction 15 K Complexes, 281 1 Introduction to EEG Interpretation, 3 16 Lambda Waves, 291 17 Low-Voltage EEG and Electrocerebral Inactivity, 297 Section II | Categorization 18 Mittens, 307 2 Identifying EEG Patterns by Their Features, 19 19 Needle Spikes, 311 20 Paroxysmal Fast Activity, 317 Section III | Patterns 21 Periodic Epileptiform Discharges, 331 3 Alpha Activity, 33 22 Phantom Spike and Wave, 353 4 Artifacts, 71 23 Photic Stimulation Responses, 359 5 Benign Epileptiform Transients of Sleep, 117 24 Positive Occipital Sharp Transients of Sleep, 371 6 Beta Activity, 127 25 Posterior Slow Waves of Youth, 377 7 Breach Effect, 141 26 Saw-tooth Waves of REM Sleep, 383 8 Burst-suppression Pattern, 151 27 Sleep Spindles, 391 9 Cone Waves, 165 28 Subclinical Rhythmic Electrographic Discharge of Adults, 401 10 Delta Activity, 169 29 Theta Activity, 413 11 Fourteen and Six Per Second Positive Bursts, 197 30 Triphasic Pattern, 433 12 Hypersynchronous Slowing, 203 31 Vertex Sharp Transients, 443 13 Ictal Epileptiform Patterns, 217 14 Interictal Epileptiform Patterns, 249 Index, 451 ix (c) 2015 Wolters Kluwer. All Rights Reserved. LWBK1139-FM_i-x.indd 9 1/3/13 3:00 PM
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