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Standard Electroencephalography in Clinical Psychiatry: A Practical Handbook (Wiley Practical Handbooks for Psychiatry Series) PDF

190 Pages·2011·15.29 MB·English
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fm JWST034/Bourtros January6,2011 18:0 PrinterName:YettoCome P1:OTE/OTE/SPH P2:OTE Standard Electroencephalography in Clinical Psychiatry Standard Electroencephalography in Clinical Psychiatry: A Practical Handbook, First Edition Edited by Nash Boutros, Silvana Galderisi, Oliver Pogarell and Silvana Riggio © 2011 John Wiley & Sons, Ltd. ISBN: 978-0-470-74782-7 fm JWST034/Bourtros January6,2011 18:0 PrinterName:YettoCome P1:OTE/OTE/SPH P2:OTE Other Titles in the Wiley Practical Handbooks for Psychiatry Series The Old Age Psychiatry Handbook: A practical guide JoanneRodda,NiallBoyceandZuzanaWalker 9780470060155 Intellectual Disability Psychiatry: A practical handbook EditedbyAngelaHassiotis,DianaAndreaBarronandIanHall 9780470742518 The Child and Adolescent Psychiatry Handbook: An evidence-based approach CharlotteBoyce,DarrenCutinha,ReneeBartonandEilisKennedy 9780470745670 fm JWST034/Bourtros January6,2011 18:0 PrinterName:YettoCome P1:OTE/OTE/SPH P2:OTE Standard Electroencephalography in Clinical Psychiatry A practical handbook Edited by Nash Boutros Wayne State University School of Medicine, Detroit, MI, USA Silvana Galderisi Department of Psychiatry, University of Naples SUN, Naples, Italy Oliver Pogarell Ludwig-Maximilian-University of Munich, Munich, Germany Silvana Riggio Mount Sinai School of Medicine and James J. Peters VAMC, New York, NY, USA A John Wiley & Sons, Ltd., Publication fm JWST034/Bourtros January6,2011 18:0 PrinterName:YettoCome P1:OTE/OTE/SPH P2:OTE Thiseditionfirstpublished2011(cid:1)c 2011byJohnWiley&Sons,Ltd. Wiley-BlackwellisanimprintofJohnWiley&Sons,formedbythemergerofWiley’sglobalScientific, TechnicalandMedicalbusinesswithBlackwellPublishing. RegisteredOffice: JohnWiley&Sons,Ltd,TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ, UK EditorialOffices: 9600GarsingtonRoad,Oxford,OX42DQ,UK TheAtrium,SouthernGate,Chichester,WestSussex,PO198SQ,UK 111RiverStreet,Hoboken,NJ07030-5774,USA Fordetailsofourglobaleditorialoffices,forcustomerservicesandforinformationabouthowtoapplyfor permissiontoreusethecopyrightmaterialinthisbookpleaseseeourwebsiteatwww.wiley.com/wiley-blackwell. TherightoftheauthortobeidentifiedastheauthorofthisworkhasbeenassertedinaccordancewiththeUK Copyright,DesignsandPatentsAct1988. Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrievalsystem,ortransmitted,in anyformorbyanymeans,electronic,mechanical,photocopying,recordingorotherwise,exceptaspermittedby theUKCopyright,DesignsandPatentsAct1988,withoutthepriorpermissionofthepublisher. Designationsusedbycompaniestodistinguishtheirproductsareoftenclaimedastrademarks.Allbrandnames andproductnamesusedinthisbookaretradenames,servicemarks,trademarksorregisteredtrademarksoftheir respectiveowners.Thepublisherisnotassociatedwithanyproductorvendormentionedinthisbook.This publicationisdesignedtoprovideaccurateandauthoritativeinformationinregardtothesubjectmattercovered. Itissoldontheunderstandingthatthepublisherisnotengagedinrenderingprofessionalservices.Ifprofessional adviceorotherexpertassistanceisrequired,theservicesofacompetentprofessionalshouldbesought. LibraryofCongressCataloging-in-PublicationData Standardelectroencephalographyinclinicalpsychiatry:apracticalhandbook/NashBoutros...[etal.]. p.cm. Includesindex. Summary:“ThisbookprovidesaconciseoverviewofthepossibleclinicalapplicationsofstandardEEGin clinicalpsychiatry.ItstartswithashorthistorythendescribesthephysiologicbasisoftheEEGsignal.The materialisclearlypresentedthroughout,withfigures,tableswithsummariesofrelevantfindings,flowdiagrams fordiagnosticwork-up,boxeswithlearningpoints,andshortlistsofkeyreferences”–Providedbypublisher. Summary:“ThisbookprovidesaconciseoverviewofthepossibleclinicalapplicationsofstandardEEGin clinicalpsychiatry”–Providedbypublisher. ISBN978-0-470-74782-7(pbk.) 1.Electroencephalography. 2.Psychiatry. 3.Mentalillness–Diagnosis. I.Boutros,NashaatN. RC386.6.E43S732011 616.8(cid:1)047547–dc22 2010047247 AcataloguerecordforthisbookisavailablefromtheBritishLibrary. Thisbookispublishedinthefollowingelectronicformats:eBook9780470974629;WileyOnlineLibrary 9780470974612;ePub9780470974940 Setin10.5/13ptBembobyAptaraInc.,NewDelhi,India. FirstImpression2011 fm JWST034/Bourtros January6,2011 18:0 PrinterName:YettoCome P1:OTE/OTE/SPH P2:OTE Contents List of Contributors ix Preface xi 1 Historical Review of Electroencephalography in Psychiatry 1 NashBoutros Introduction 1 Theearlypre-clinicalera 1 Earlyhistoryofhumanelectroencephalography 3 Electroencephalographyinpsychiatrytoday 5 References 5 2 Physiologic Basis of the EEG Signal 7 PaolaBucciandSilvanaGalderisi Membranepotentials 7 Excitatoryandinhibitorypostsynapticpotentials 8 NonsynapticintercellulareventscontributingtotheEEGsignal 8 FactorsdeterminingpolarityandothercharacteristicsofthesurfaceEEGwaveforms 8 BrainstructuresinvolvedinthegenesisofEEGrhythms 10 References 12 3 EEG Recording and Analysis 13 OliverPogarell Techniquesandtechnicalbackground 13 References 30 4 Normal EEG Patterns and Waveforms 33 PaolaBucci,ArmidaMucciandSilvanaGalderisi Introduction 33 NormalEEGpatternsinthewakingadult 35 References 54 fm JWST034/Bourtros January6,2011 18:0 PrinterName:YettoCome P1:OTE/OTE/SPH P2:OTE vi CONTENTS 5 Abnormal Patterns 59 OliverPogarell Introduction 59 Detectionofartefacts 60 Abnormalpatterns 60 Focalalterations 68 References 76 6 The Role of EEG in the Diagnostic Work Up in Psychiatry: Nonconvulsive Status Epilepticus, Frontal Lobe Seizures, Non-Epileptic Seizures 77 SilvanaRiggio Nonconvulsivestatus 77 Psychogenicnon-epilepticseizures 81 Frontallobeseizures 85 References 88 7 EEG in Childhood Psychiatric Disorders 91 MaryW.RobertsandNashBoutros Introduction 91 Attentiondeficitdisorder 92 Autisticspectrumdisorders 100 References 108 8 EEG in Psychoses, Mood Disorders and Catatonia 113 NashBoutros,SilvanaGalderisi,OliverPogarellandFelixSegmiller Introduction 113 EEGinpsychoses 114 EEGinmooddisorders 123 EEGfindingsincatatonia 124 References 129 9 Standard EEG in Personality and Anxiety Disorders 133 NashBoutros Introduction 133 EEGinaggressionandimpulsedyscontrol 133 Panicattacks 138 Borderlinepersonalitydisorder 142 References 144 10 EEG in Delirium and Dementia 147 SophiaWangandSilvanaRiggio Introduction:Epidemiologyofdeliriumanddementia 147 Clinicaldiagnosisindelirium 149 EEGworkupindelirium 150 fm JWST034/Bourtros January6,2011 18:0 PrinterName:YettoCome P1:OTE/OTE/SPH P2:OTE CONTENTS vii Metaboliccausesofdelirium 151 Infectiouscausesofdelirium 154 ClinicaldiagnosisandEEGworkupindementia 155 Conclusion 158 References 159 11 Effects of Psychotropic Drugs on EEG 163 SilvanaGalderisiandArmidaMucci Introduction 163 TheroleofEEGassessmentofdrug-inducedCNStoxicityinpsychiatricpatients 163 Antipsychoticdrugs 164 Lithium 166 Othermoodstabilisers 167 Anxiolytics 168 Antidepressants 169 Recreationaldrugs 169 Casevignette 170 References 171 12 Certification and Training in EEG and Clinical Neurophysiology 173 NashBoutrosandSilvanaGalderisi Clinicalneurophysiologyboardcertification 173 Index 179 fm JWST034/Bourtros January6,2011 18:0 PrinterName:YettoCome P1:OTE/OTE/SPH P2:OTE List of Contributors Nash Boutros, MDProfessorofPsychiatryandNeurology,WayneStateUniversity, SchoolofMedicine.2751E,Jefferson,Detroit,MI48207,USA Paola Bucci, MD, PhDAssistantProfessorofPsychiatry,DepartmentofPsychiatry, UniversityofNaplesSUN,LargoMadonnadelleGrazie,8018Naples,Italy Silvana Galderisi, MD, PhDFullProfessorofPsychiatry,Departmentof Psychiatry,UniversityofNaplesSUN,LargoMadonnadelleGrazie,8018Naples, Italy Armida Mucci, MD, PhDAssistantProfessorofPsychiatry,Departmentof Psychiatry,UniversityofNaplesSUN,LargoMadonnadelleGrazie,8018Naples, Italy James J. Peters, VAMCNewYork,NY10029,USA Oliver Pogarell, MDAssociateProfessor,Neurologist,Psychiatrist,Departmentof PsychiatryandPsychotherapy,Ludwig-Maximilian-UniversityofMunich, Nussbaumstr.7,D-80336Munich,Germany Silvana Riggio, MDProfessorofPsychiatryandNeurology,MountSinaiSchoolof MedicineandJamesJ.PetersVAMC,NewYork,NY,USA Mary Roberts, MDClinicalAssociateProfessorofPsychiatry,WayneState University,SchoolofMedicine,2751E.Jefferson,Detroit,MI,48207,USA Felix Segmiller, MDDepartmentofPsychiatryandPsychotherapy, Ludwig-Maximilian-UniversityofMunich,Nussbaumstr.7,D-80336Munich, Germany Sophia Wang, MDPsychiatryDepartment,MountSinaiSchoolofMedicine,New York,NY,USA fm JWST034/Bourtros January6,2011 18:0 PrinterName:YettoCome P1:OTE/OTE/SPH P2:OTE Preface Electroencephalography(EEG)isanimportant,non-invasivefunctionalmethodforthe investigation of electrical activity in the brain. EEG alone, or at times in combina- tion with video EEG monitoring, is a very useful tool in the differential diagnosis of psychiatric and/or neurological presentations. It can also be useful for monitoring and helping to evaluate the clinical or therapeutic course of psychiatric disorders and to guidetreatmentplans. The idea of a practical handbook on Standard Electroencephalography in Clinical Psy- chiatry was originally conceived by Dr N. Boutros following many discussions amongst membersoftheEEGandClinicalNeurosciencesSociety.Thesediscussionsconcerned the relative roles of the standard (visually inspected) EEG (EEG) and the quantified EEG (QEEG) in clinical psychiatry. They resulted in the firm conclusion that both techniques are important and that they are complementary. While a number of texts addressing QEEG applications in psychiatry have been published in recent years, the last book addressing EEG in psychiatry was that by John R. Hughes and William P. Wilson[1]from1983.Wethereforestartedtocompilethisbook,whichintegratesour combined knowledge and will serve as a comprehensive and practical guide to assist psychiatristsinclinicaldecisionmakingusingEEG. Thisbookwasenvisionedasapracticalguidetoassistpsychiatristsinclinicaldecision makingusingEEG.ItreviewsthebasicsofanormalandabnormalEEGexam,thevalue and the limitations of EEG testing and its clinical indications. Specific clinical pitfalls andpearls,thatare‘redflags’,intheEEGassessmentarestressedthroughoutthebook. Despite the fact that we have had the ability to record brain electrical potential since 1924 and that this work was spearheaded by Dr Berger, a psychiatrist, to this day the significance of some EEG changes present in psychiatric patients remains poorly understood. The scalp-recorded visually inspected standard EEG is an under-utilised tool in the assessment of patients with a psychiatric diagnosis: failure to utilise this tool may contribute to a delay in making an accurate diagnosis and initiating appropriate therapy. The EEG is an essential tool in the differential diagnosis of neurological ver- sus psychiatric disorders, especially when performed in correlation with the clinical manifestations and when special techniques such as video monitoring recording are used.

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This book provides a concise overview of the possible clinical applications of standard EEG in clinical psychiatry. After a short history, the book describes the physiologic basis of the EEG signal, then reviews the principles of EEG in terms of technical backgrounds and requirements, EEG recording
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