Atlas of EEG, Seizure Semiology, and Management, 2nd Edition

384 Pages·2013·39.23 MB·English

Atlas of EEG, Seizure Semiology,
and Management
This page intentionally left blank
Atlas of EEG,
Seizure Semiology,
and Management
SECOND EDITION
KARL E. MISULIS
VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
NASHVILLE TENNESSEE
& WEST TENNESSEE HEALTHCARE
JACKSON, TENNESSEE
1
3

Oxford University Press is a department of the University of Oxford.
It furthers the University’s objective of excellence in research, scholarship,
and education by publishing worldwide.
Oxford New York
Auckland Cape Town Dar es Salaam Hong Kong Karachi
Kuala Lumpur Madrid Melbourne Mexico City Nairobi
New Delhi Shanghai Taipei Toronto
With offi ces in
Argentina Austria Brazil Chile Czech Republic France Greece
Guatemala Hungary Italy Japan Poland Portugal Singapore
South Korea Switzerland Th ailand Turkey Ukraine Vietnam
Oxford is a registered trademark of Oxford University Press
in the UK and certain other countries.
Published in the United States of America by
Oxford University Press
198 Madison Avenue, New York, NY 10016
© Oxford University Press 2014
All rights reserved. No part of this publication may be reproduced, stored in
a retrieval system, or transmitted, in any form or by any means, without the prior
permission in writing of Oxford University Press, or as expressly permitted by law,
by license, or under terms agreed with the appropriate reproduction rights organization.
Inquiries concerning reproduction outside the scope of the above should be sent to the
Rights Department, Oxford University Press, at the address above.
You must not circulate this work in any other form
and you must impose this same condition on any acquirer.
Library of Congress Cataloging-in-Publication Data
Misulis, Karl E.
Atlas of EEG, Seizure Semiology, and Management / Karl E. Misulis.—2nd ed.
p. ; cm.
Rev. ed. of: Atlas of EEG & seizure semiology / Bassel Abou-Khalil, Karl E. Misulis. c2006.
Includes bibliographical references and index.
ISBN 978–0–19–998590–6 (alk. paper)—ISBN 978–0–19–998591–3 (alk. paper)—
ISBN 978–0–19–998592–0 (alk. paper)
I. Misulis, Karl E. Atlas of EEG & seizure semiology. III. Title.
[DNLM: 1. Electroencephalography—methods—Atlases. 2. Seizures—diagnosis—Atlases.
3. Seizures—therapy—Atlases. WL 17]
RC386.6.E43
616.8′047547—dc23
2013010299
Th e science of medicine is a rapidly changing fi eld. As new research and clinical experience broaden our
knowledge, changes in treatment and drug therapy occur. Th e author and publisher of this work have
checked with sources believed to be reliable in their eff orts to provide information that is accurate and
complete, and in accordance with the standards accepted at the time of publication. However, in light of
the possibility of human error or changes in the practice of medicine, neither the author, nor the publisher,
nor any other party who has been involved in the preparation or publication of this work warrants that the
information contained herein is in every respect accurate or complete. Readers are encouraged to confi rm
the information contained herein with other reliable sources, and are strongly advised to check the product
information sheet provided by the pharmaceutical company for each drug they plan to administer.

9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
TABLE OF CONTENTS
Preface • vii
Acknowledgments • ix
1. Introduction to EEG • 1
2. Basic Science of EEG • 6
3. EEG Technology • 3 0
4 . C linical EEG • 8 0
5. Seizure Semiology • 235
6. Diff erential Diagnosis • 252
7. Seizure Management • 269
8. Samples and Case Discussions • 305
A ppendix: R eferences and Glossary • 3 53
Index • 363
v
This page intentionally left blank
PREFACE
It has been fi ve years since the original edition of this book. Science and clinical practice have
moved on at a rapid pace, with advances in technology, clinical understanding, and diagnostic strat-
egies. In this second edition, Dr. Abou-Khalil and I have substantially expanded and updated the
material in the text, we have added a major section on seizure management, and we have expanded
the section on case studies. We recognize that the busy clinician not only wants a guide to evalu-
ation and diagnosis, but also a guide to medical and non-medical management of disorders. Note
that management strategies come and go and evolve, so this material must be supplemented by
current literature and scientifi c data.
Th is book covers the basics of EEG including basic science, technology, performance, interpre-
tation, seizure semiology, diff erential diagnosis, and seizure management. Th is book concentrates
on areas that are the specifi c domain of the authors, inpatient and outpatient EEG and epilepsy,
mainly in adults. While there is some discussion of pediatric EEG, intraoperative monitoring, and
advanced techniques, these sections are limited and are not the principal focus of this work.
Th e authors chose to adhere mainly to the older and more widely used seizure and epilepsy
classifi cation schemes rather than the less widely used yet thoughtful schemes that are in develop-
ment. However, this edition includes presentation of the most recent recommended classifi cation
schemes. It should be noted that these schemes are not fully developed and are not universally
accepted. In an eff ort to keep this work at a manageable size, the authors have had to be selective,
and as a result have omitt ed or limited discussion of some clinical and electrophysiological entities.
Th e information contained in this work is distilled from many years of clinical experience and
many scientifi c papers. In this concise text, it was impossible to list all of these valuable works.
vii
This page intentionally left blank
ACKNOWLEDGMENTS
Th e author would like to extend his sincere appreciation to technicians involved in the performance
of these studies. Also, numerous colleagues have provided material as well as feedback on the fi rst
edition of this text. Special thanks are extended to my son, Karl C. Misulis for extensive work on
the digital imaging, and Riki Rager R. EEG T., B.S., FASET for help with the technical portions
of this text. Th e author would like to extend great appreciation to colleague, coauthor, and friend,
Dr. Bassel Abou-Khalil, who contributed substantially not only to his authored chapters but also to
much of the rest of the manuscript.

ix