Clinical electroencephalography

✍ Scribed by Oriano Mecarelli (editor)

• Publisher: Springer
• Year: 2019
• Tongue: English
• Leaves: 809
• Category: Library

✦ Table of Contents

Preface
Acknowledgements
Contents
Contributors
Part I: Technical Aspects and Normal EEG Patterns
1: Past, Present and Future of the EEG
References
2: Neurophysiological Basis of EEG
2.1 Central Nervous System: Anatomo-physiological Considerations
2.2 Origin of the Electrical Activity of the Brain
2.3 Focus on Alpha Rhythm
2.4 Origin of Slow Brain Rhythms
References
3: Scalp and Special Electrodes
3.1 General Characteristics of Electrodes
3.2 Electrode Chloridation
3.3 Standard Recording Electrodes
3.4 Recent Developments: Dry and Active Electrodes
3.5 Special Electrodes
3.5.1 Sphenoidal Electrodes
3.5.2 Naso-Ethmoidal Electrodes
3.5.3 Nasopharyngeal Electrodes
3.5.4 Zygomatic Electrodes
3.5.5 Supraorbital Electrodes
3.5.6 Tympanic Electrodes
3.6 Infection Control
Appendix: Electro-Physical Characteristics of Electrodes
References
4: Electrode Placement Systems and Montages
4.1 Traditional International 10-20 System
4.2 Modification of 10-20 System (10-10 System)
4.3 Proposed 10-5 System for High-Resolution EEG
4.4 Final Recommendations
4.5 Electrode Derivations and Montages
4.5.1 Reference Derivations
4.5.1.1 Common Reference
4.5.1.2 Common Average Reference
4.5.1.3 Source Derivation
4.5.1.4 Bipolar Derivations
4.5.1.5 Choice of Derivation in Clinical Practice
4.5.2 Montages
References
5: EEG Signal Acquisition
5.1 Introduction
5.1.1 Digital EEG System Structure
5.2 Analogue Components
5.2.1 EEG Signal Detection: The Electrodes
5.2.2 EEG Acquisition System: The Differential Amplifier
5.2.3 EEG Acquisition Technique: Common Reference and Bipolar Electrodes
5.2.4 EEG Acquisition System: Noise
5.3 Analogue-To-Digital Conversion
5.3.1 Sampling
5.3.2 Quantization
5.3.3 Decimation
5.3.4 Summary of the Parameters of EEG Signal Acquisition
5.3.5 Examples of Other Analogue-To-Digital Conversion Processes
5.4 The Digital Component
5.4.1 EEG Signal Storage
5.4.2 EEG Signal Digital Processing
5.4.3 EEG Signal Display
5.4.4 EEG Signal Printout
5.5 Synchronized Digital Video
5.5.1 Digital Video EEG Acquisition
5.5.2 Video Signal Digitalization
5.5.3 Digital Video Compression
5.5.4 Digital Video File Display
Appendix 1: The Aliasing
Appendix 2: Source Reference
Reference
6: EEG Signal Analysis
6.1 Introduction
6.2 EEG Signal Analysis in the Frequency Domain
6.2.1 EEG Parameters in the Frequency Domain
6.2.2 Data Calculation
6.3 EEG Signal Analysis in the Time Domain
6.3.1 EEG Parameters in the Time Domain
6.4 Data Display Technique
6.4.1 Display of Data Evolution over Time
6.4.2 Display of Spatial Distribution of Data
6.4.2.1 Spatial Sampling
6.4.2.2 Scalp Models
6.4.2.3 Interpolation Techniques
6.4.2.4 Choice of the Reference in Cerebral Mapping
6.5 Examples
References
7: EEG Laboratory: Patient Care and the Role of the EEG Technician
7.1 Environment, Patient Care, and Recording Preparation
7.2 Electrode Placement and Control
7.3 EEG Recording
7.4 Ictal Event Recordings and EEG report
7.5 Networked EEG Laboratory.
References
8: Artifacts
8.1 Artifact Classification
8.1.1 Physiological Artifacts
8.1.1.1 Eye Movement Artifacts
8.1.1.2 Muscle Artifacts
8.1.1.3 Glossokinetic Artifact
8.1.1.4 Electrocardiogram Artifact
8.1.1.5 Pulse Artifact
8.1.1.6 Cardiac Pacing Artifact
8.1.1.7 Electrodermogram Artifacts
8.1.1.8 Respiratory Artifacts
8.1.1.9 Tremor Artifact
8.1.1.10 Other Movement Artifacts
8.1.2 Artifacts due to the Acquisition System
8.1.2.1 Interelectrode “Salt Bridge” Artifact
8.1.2.2 Bad Skin-Electrode Contact Artifact
8.1.2.3 Electrode Pressure Artifacts
8.1.2.4 Bad Electrode-Clamp and Connector-Headbox Contact Artifacts
8.1.2.5 Artifacts Generated from Rhythmic Oscillations of the Cables
8.1.3 Electrical Interference and External Equipment Artifacts
8.1.3.1 Alternating Current Artifact
8.1.3.2 Telephone Artifact
8.1.3.3 Switch Artifacts
8.1.3.4 Mechanical and Device-Related Artifacts
Mechanical Ventilation
Hemodialysis and Hemofiltration Devices
Electrosurgical Devices
Swan-Ganz Catheter
External Cardiac Pacemaker Artifact
References
9: Normal Awake Adult EEG
9.1 General Characteristics of the EEG Signals
9.2 EEG Frequencies
9.3 The Physiological Rhythms and Normal Graphoelements
9.3.1 Alpha Rhythm
9.3.1.1 Genesis of the Alpha Rhythm
9.3.2 Mu Rhythm (μ)
9.3.3 Breach Rhythm
9.3.4 Lambda Waves
9.4 Intraindividual and Interindividual Variability of the Normal Awake Adult EEG
9.5 Age Effect on the EEG of Wakefulness
9.6 The Concept of Normality of EEG
References
10: Normal Sleep EEG
10.1 Sleep EEG Recordings, Why and When
10.2 General Rules of Sleep Stages Scoring
10.3 Bases of Sleep Regulation
10.4 EEG Changes During Sleep, General Concepts
10.5 Sleep Onset
10.6 Deep Drowsiness (Stage N1 Sleep)
10.6.1 Vertex Sharp Waves (V Wave)
10.6.1.1 Vertex Sharp Waves Across the Life Span
10.6.2 POSTs (Positive Occipital Sharp Transients of Sleep)
10.7 Light Sleep (Stage N2 Sleep)
10.7.1 K-Complexes
10.7.1.1 KC Across the Life Span
10.7.1.2 KC as Arousal Phenomena
10.7.1.3 KC as Slow Wave
10.7.2 Sleep Spindles
10.7.2.1 Sleep Spindles Across the Life Span
10.7.2.2 Spindles and Slow-Wave Activity (SWA)
10.8 Deep Sleep (Stage N3 Sleep)
10.8.1 Slow-Wave Activity (SWA)
10.8.1.1 SWA Across the Life Span
10.9 REM Sleep
10.9.1 SWTs (Sawtooth Waves)
10.10 Microstructure of Sleep and the Cyclic Alternating Pattern (CAP)
10.10.1 Definitions of CAP and Non-CAP
10.10.1.1 CAP Phase A Boundaries
Amplitude Limits
Temporal Limits
10.10.1.2 Phase A EEG Events and Subtypes
10.10.2 Measures of CAP and CAP trend During Age Span
References
11: Normal Neonatal EEG
11.1 Neonatal EEG Features
11.2 Historical References
11.3 Qualitative Analysis of the Signal
11.4 Registration Techniques
11.5 Preparation of the Newborn
11.6 Positioning of the Electrodes
11.7 Polygraphic Parameters
11.8 Digital Video EEG
11.9 Maturation of Behavioral and EEG Patterns: From Prematurity to the End of the Neonatal Period
11.9.1 Behavioral Patterns
11.9.2 Physiological EEG Patterns
11.10 Amplitude-Integrated EEG (aEEG)
Appendix
References
12: Normal Variants and Unusual EEG Patterns
12.1 Normal Variants
12.1.1 Slow Physiological Posterior Activities
12.1.1.1 Slow Alpha Variant
12.1.1.2 Posterior Theta Rhythm
12.1.1.3 Posterior Slow Waves
12.1.1.4 Lambda Waves
12.1.2 Mu Rhythm
12.2 Unusual Benign Epileptiform Patterns
12.2.1 Midline Theta Rhythm
12.2.2 Rhythmic Theta Bursts of Drowsiness or Rhythmic Mid-temporal Discharges or Psychomotor Variant
12.2.3 Subclinical Rhythmic Electrographic Discharges of Adults
12.2.4 Wicket Spikes or Wicket Rhythms
12.2.5 14- and 6-Hz Positive Bursts
12.2.6 Phantom Spikes and Waves or 6-Hz Spikes and Waves
12.2.7 Small Sharp Spikes
12.3 Conclusion
References
13: Pathological EEG Patterns
13.1 Changes in Background Rhythms
13.2 Slowings
13.3 Epileptiform Abnormalities
13.4 Periodic and Rhythmic Patterns
13.4.1 Periodic Patterns
13.4.2 Rhythmic Patterns
13.4.2.1 Rhythmic Delta Activity
13.4.2.2 Stimulus-Induced Rhythmic, Periodic, or Ictal Discharges
13.5 Attenuation/Suppression and Electrocerebral Inactivity
References
14: Activation Procedures
14.1 Hyperventilation
14.1.1 Normal EEG Changes Induced by HV
14.1.2 Abnormal EEG Changes Induced by HV
14.1.3 Pathophysiological Changes Induced by HV
14.2 Intermittent Photic Stimulation
14.2.1 Methodology
14.2.2 IPS-Induced EEG Changes
14.2.2.1 Photic Driving Response
14.2.2.2 Photomyogenic Response
14.2.2.3 Photoparoxysmal Response
14.3 Other Methods of Visual Stimulation
14.3.1 Pattern Stimulation
14.3.2 Low-Luminance Visual Stimulation
14.3.3 Fixation-Off Sensitivity
14.4 Sleep and Sleep Deprivation
14.5 Other Stimulation
References
15: Polygraphic Techniques
15.1 Polygraphy Room
15.1.1 Equipment
15.2 Polygraphic Parameters
15.2.1 Capturing Signals with Electrodes
15.2.2 Bioelectrical Parameters
15.2.2.1 EEG
15.2.2.2 EOG
15.2.2.3 EMG
15.2.2.4 ECG
15.2.2.5 SSR
15.3 Non-electrical Parameters
15.3.1 Breathing
15.3.1.1 Oronasal Flow
15.3.1.2 Thoracic and Abdominal Activity
15.3.1.3 Endoesophageal Pressure
15.3.2 Noise
15.3.3 Body Position
15.3.4 Pulse Oximetry
15.3.5 Plethysmogram
15.4 Ambulatory Monitoring
15.4.1 Actigraph
15.5 Conclusion
References
16: Polygraphic Investigations and Back-Averaging Techniques in the Study of Epileptic Motor Phenomena
16.1 Introduction
16.2 Polygraphic Features of Epileptic Motor Manifestations
16.2.1 Myoclonus
16.2.2 Spasms
16.2.3 Tonic Contractions
16.2.4 Clonic Contractions
16.2.5 Atonic Phenomena
16.3 Polygraphic Patterns in Different Types of Epileptic Seizures or Syndromes
16.3.1 Generalized Tonic-Clonic Seizures
16.3.2 Tonic Seizures
16.3.3 Myoclonic Absences
16.3.4 Juvenile Myoclonic Epilepsy
16.3.5 Epilepsia Partialis Continua
16.3.6 Progresive Myoclonus Epilepsies
16.4 Some Reflections on EEG-EMG Correlations in Epileptic Seizures
16.5 Back-Averaging Techniques Applied to the Analysis of Polygraphic Signals
16.5.1 Back-Averaging Applications to the Study of Myoclonus
16.5.1.1 EMG correlates of Positive and Negative Myoclonus
16.5.1.2 EEG Correlates of Positive and Negative Myoclonus
16.5.2 Averaging Techniques to Study Negative Motor Phenomena
16.6 Conclusions
References
17: Ambulatory EEG
17.1 Ambulatory EEG Equipment
17.1.1 Electrode Placement and Instructions for the Patient
17.1.2 Clinical Utility of Ambulatory EEG
17.1.3 Limitations and Pitfalls
References
18: Video-Electroencephalography (Video-EEG)
18.1 General Indications
18.2 Methodology
18.3 Indications and Limits
18.4 Technical Features
18.4.1 Electrodes
18.4.2 Maintenance
18.4.3 EEG Amplifiers
18.4.4 Montage
18.4.5 Online Computed Analysis
18.4.6 Video Recordings
18.4.7 Activation Techniques
18.4.8 Testing the Patient during Seizures
18.4.9 Pharmacological Treatment
18.4.10 Safety
18.4.11 Guidelines for Video-EEG Monitoring Laboratory
18.4.12 Storage
18.4.13 Report
18.5 Conclusion
References
19: Invasive EEG
19.1 General Indications
19.2 Introduction
19.3 Methodologies
19.4 The Epileptogenic Zone: Meaning and Definition
19.5 Subdural Electrodes and Combination of Subdural/Depth Electrodes
19.5.1 Surgical Technique
19.5.2 Recordings
19.5.3 Strong Points and Limits
19.5.4 Risks
19.6 Stereo-EEG
19.6.1 Surgical Technique
19.6.2 Recordings
19.6.3 Strong Points and Limits
19.6.4 Risks
19.7 Intraoperative Electrocorticography (ECoG)
19.7.1 Technique
19.7.2 Strong Points and Limits
19.7.3 Electrical Stimulations (ES)
19.8 Conclusion
References
20: Electromagnetic Source Imaging, High-Density EEG and MEG
20.1 Introduction
20.2 Cortical Generators of Epileptiform Discharges
20.3 Topographic Maps
20.4 Source Reconstruction
20.4.1 Forward Solution
20.4.2 Inverse Solution
20.5 High-Density EEG (HD-EEG) Recordings
20.6 Magnetoencephalography (MEG) Recordings
20.7 Methodological Steps of Source Imaging
20.8 Evidence from Clinical Validation Studies
20.9 Limitations and Future Direction
References
21: Simultaneous Recording EEG and fMRI
21.1 Neural Basis of BOLD Signal and Rationale of Simultaneous Recording EEG and fMRI
21.2 EEG-fMRI in Epilepsy
21.3 EEG Artefacts due to Recording in the MR Scan
21.4 MRI Artefacts due to EEG Equipment
21.5 Modelling the EEG Signal to Inform fMRI Analysis
21.6 Variability of the Haemodynamic Response Function
21.7 The Negative BOLD Response
21.8 Sensitivity and Reproducibility in Epilepsy Studies
21.9 EEG-fMRI in Children and Adolescents
21.10 Clinical Utility of EEG-fMRI Studies
References
Part II: Pathological EEG Patterns
22: Abnormal Neonatal Patterns
22.1 Abnormal Neonatal EEG
22.2 Introduction
22.3 Extra Cerebral Artifacts
22.4 The Abnormal EEG Recording: Historical References
22.5 Methodological Approach
22.5.1 EEG Recording
22.6 Essential Terminology
22.7 Iconography of the Abnormal EEG
References
23: Early-Onset Epileptic Encephalopathies
23.1 Introduction
23.2 Ohtahara Syndrome
23.3 Early Myoclonic Encephalopathy
23.4 Other Early-Onset Epileptic Encephalopathies due to Specific Genetic Aetiology
23.4.1 CDKL5-Related Epileptic Encephalopathy (OMIM 300672)
23.4.2 KCNQ2-Related Epileptic Encephalopathy (OMIM 613720)
23.4.3 SCN2A-Related Epileptic Encephalopathy (OMIM 613721)
23.4.4 SCN8A-Related Epileptic Encephalopathy (OMIM 614558)
References
24: Epileptic Encephalopathies of Infancy and Childhood
24.1 Introduction
24.2 West Syndrome
24.3 Dravet Syndrome
24.4 Lennox-Gastaut Syndrome
24.5 Epilepsy with Myoclonic-Astatic Seizures (Doose Syndrome)
24.6 Progressive Myoclonic Epilepsies
24.7 Landau-Kleffner Syndrome
24.8 Electrical Status Epilepticus During Slow Sleep
References
25: Focal “Idiopathic” Epilepsies of Infancy
25.1 Introduction
25.2 Rolandic Epilepsy (or Benign Childhood Epilepsy with Centrotemporal Spikes)
25.2.1 Interictal EEG
25.2.2 Ictal EEG
25.2.3 Atypical Evolution
25.3 Early-Onset Epilepsy with Occipital Paroxysms (Panayiotopoulos Syndrome)
25.3.1 Interictal EEG
25.3.2 Ictal EEG
25.3.3 Atypical Evolution
25.4 Late-Onset Childhood Epilepsy with Occipital Paroxysms (Gastaut Type)
25.4.1 Interictal EEG
25.4.2 Ictal EEG
25.5 Other “Minor” Localization-Related Self-Limited Genetic Epilepsies
25.6 Non-familial and Familial Benign Infantile Seizures (Watanabe-Vigevano Syndrome)
25.6.1 Interictal and Ictal EEG
References
26: Non-age-Related Focal Epilepsies
26.1 Introduction
26.2 Temporal Lobe Epilepsy
26.2.1 Mesial Temporal Lobe Epilepsy (MTLE)
26.2.1.1 Interictal EEG Features
26.2.1.2 Ictal Clinical EEG Semiology
26.2.2 Lateral Neocortical Temporal Lobe Epilepsy (LNTLE)
26.2.2.1 Interictal EEG Features
26.2.2.2 Ictal Clinical EEG Semiology
26.3 Frontal Lobe Epilepsies
26.3.1 Interictal and Ictal EEG Features
26.4 Occipital Lobe Epilepsies
26.4.1 Interictal and Ictal EEG
26.5 Parietal Lobe Epilepsies
26.5.1 Interictal and Ictal EEG Features
26.6 Epilepsy with Gelastic Seizures
26.7 Rasmussen’s Syndrome
26.8 Conclusions
References
27: Genetic Generalized Epilepsies
27.1 Childhood Absence Epilepsy (CAE)
27.1.1 EEG Features
27.2 Juvenile Absence Epilepsy (JAE)
27.2.1 EEG Features
27.3 Juvenile Myoclonic Epilepsy (JME) (Janz Syndrome)
27.3.1 Neurophysiology
27.4 Epilepsy with Generalized Tonic-Clonic Seizures Alone (GTCSa)
27.5 Eyelid Myoclonia with/Without Absences (EMA) (Jeavons Syndrome)
27.6 Lifestyle and Drugs Can Influence EEG in GGE
27.7 Conclusion
References
28: Reflex Seizures and Reflex Epilepsies
28.1 Introduction to Reflex Seizures and Reflex Epilepsies
28.2 Epileptic Seizures and Reflex Epilepsy Related to Visual Stimuli
28.3 Reflex Epilepsy Calculation or Other Higher-Level Cortical Processes and by Complex Motor Performances
28.4 Primary Reading Epilepsy
28.5 Startle Epilepsy
28.6 Eating Epilepsy
28.7 Musicogenic Epilepsy
28.8 Hot Water Epilepsy
28.9 Other Unusual Seizure Triggers
28.10 Reflex Seizures in Patients with Malformations of Cortical Development
28.11 Conclusions
References
29: Photosensitivity and Epilepsy
29.1 Introduction
29.2 Important Issues
29.2.1 Why Do We Use Intermittent Photic Stimulation? How Was It Discovered to Be a Valuable Tool in Epilepsy Diagnostics and Research?
29.2.2 Photomyoclonic, Photoconvulsive, and Photoparoxysmal Responses: How to Use the Respective Terms Nowadays?
29.2.3 Photoparoxysmal Responses (PPRs) Outlasting the Stimulus or Not: Is It Relevant?
29.2.4 Does a PPR Equals a Seizure?
29.2.5 Does Photosensitivity Mean “Automatically” that the Patient Has Genetic Generalized Epilepsy (Formerly Known as Idiopathic Generalized Epilepsy)?
29.2.6 Is any Type of Photostimulator Appropriate?
29.2.7 Why Testing Different Eye Conditions with IPS?
29.2.8 How Can You Be Sure that a Patient Is Photosensitive?
29.2.9 Use of PPR Ranges in Evaluation of Epileptogenic Threshold and Treatment
29.3 Conclusions
References
30: Febrile Seizures and Febrile Status Epilepticus
30.1 Introduction
30.2 EEG in FS and FSE
30.3 Other Conditions with Seizures Induced by Fever
30.4 Conclusions
References
31: Paediatric Status Epilepticus
31.1 Introduction
31.2 Classification of SE
31.2.1 Convulsive Status Epilepticus
31.2.2 Nonconvulsive Status Epilepticus
31.2.3 SE Occurring in Neonatal and Infantile-Onset Epilepsy Syndromes
31.2.4 SE Occurring in Childhood and Adolescence
31.3 Ring Chromosome 20
31.4 Angelman Syndrome
31.5 Rett Syndrome
31.6 Epilepsy with Myoclonic-Atonic Seizures
31.7 Myoclonic Status in Nonprogressive Encephalopathy (MSNPE)
31.8 SE in Other Childhood Myoclonic Encephalopathies (Mitochondrial Diseases Causing SE)
31.9 Atypical Absence SE and Tonic Status in Lennox-Gastaut Syndrome
31.10 ESESS/CSWSS/Epilepsy-Aphasia Spectrum
31.11 Myoclonic Status in Progressive Myoclonus Epilepsies
31.11.1 SE Occurring Mainly in Adolescence and Adulthood
References
32: Status Epilepticus in Adults
32.1 Introduction
32.1.1 Epidemiology
32.1.2 Etiology
32.1.3 Definition and Diagnosis
32.2 EEG Pattern According to Clinical Manifestation
32.2.1 Generalized SE with Prominent Motor Signs
32.2.1.1 Tonic-Clonic SE
32.2.1.2 Tonic SE
32.2.1.3 Myoclonic SE
32.2.2 Focal SE
32.2.2.1 Focal Motor SE
32.2.2.2 Dysphasic or Aphasic SE
32.2.2.3 Focal Sensory Status Epilepticus
32.2.2.4 SE with Visual Seizures
32.2.2.5 Autonomic SE
32.2.2.6 Unilateral or Erratic SE
32.3 Diagnostic Criteria of Nonconvulsive Status Epilepticus (NCSE)
32.3.1 Historical Background
32.3.1.1 Generalized NCSE
32.3.1.2 Focal Status Without Prominent Motor Symptoms (Partial Complex SE)
32.3.2 Current Diagnostic Criteria
32.4 Suspected Epileptic Status or the “Ictal-Interictal Continuum”
32.4.1 Intermittent Rhythmic Delta Activity
32.4.2 Generalized or Lateralized Rhythmic Activity (RDA or LRDA)
32.4.3 Generalized Periodic Discharges (GPDs)
32.4.4 Lateralized Periodic Discharges (LPDs or PLEDs)
32.4.5 Triphasic Waves (TWs)
32.4.6 Stimulus-Induced Rhythmic, Periodic, or Ictal Discharges (SIRPIDs)
32.4.7 Burst-Suppression Patterns
32.5 EEG and Therapy in Status Epilepticus
32.6 Conclusion
References
33: Chromosomal Abnormalities and Cortical Malformations
33.1 Chromosomal Abnormalities
33.1.1 1p36 Deletion Syndrome
33.1.2 2q24.4 Deletion Syndrome
33.1.3 4p− Syndrome (Wolf-Hirschhorn Syndrome)
33.1.4 5q14.3 Deletion Syndrome
33.1.5 6q Terminal Deletion Syndrome
33.1.6 Trisomy 12p Syndrome
33.1.7 Ring Chromosome 14 Syndrome
33.1.8 Angelman Syndrome
33.1.9 Inv Dup (15) Syndrome
33.1.10 15q13.3 Deletion Syndrome
33.1.11 Ring Chromosome 20 Syndrome
33.1.12 Down Syndrome
33.1.13 Fragile X Syndrome
33.1.14 Klinefelter Syndrome
33.1.15 Xp11.22–11.23 Duplication Syndrome
33.1.16 XYY Syndrome
33.2 Cortical Malformations
33.2.1 Tuberous Sclerosis Complex
33.2.2 Focal Cortical Dysplasias Type II
33.2.3 Hemimegalencephaly
33.2.4 Lissencephaly
33.2.5 Subcortical Band Heterotopia (Double Cortex)
33.2.6 Bilateral Periventricular Nodular Heterotopia
33.2.7 Schizencephaly
33.2.8 Polymicrogyria
33.2.9 Focal Cortical Dysplasia Types I and III
References
34: Paroxysmal Nonepileptic Events
34.1 Syncope
34.1.1 Definition and Classification
34.1.1.1 Neurally Mediated Syncope (Reflex Syncope)
34.1.1.2 Orthostatic Hypotension Syncope
34.1.1.3 Cardiac Syncope
34.1.1.4 Syncope Secondary to Cerebrovascular Causes
34.1.2 Clinical Features
34.1.3 Diagnostic Work-Up
34.1.4 EEG Findings
34.1.5 Syncope in Epilepsy
34.2 Psychogenic Nonepileptic Seizures
34.2.1 Definition and Overview
34.2.2 Clinical Ictal Features
34.2.3 EEG Findings
34.2.3.1 Interictal EEG
34.2.3.2 Ictal EEG
34.2.3.3 Video-EEG Telemetry
34.2.4 Other Exams
References
35: Sleep Diseases
35.1 Insomnia
35.1.1 Insomnia and Instrumental Findings
35.1.2 CAP Role in Insomnia
35.2 Parasomnias
35.2.1 NREM Sleep Parasomnias (Disorders of Arousal)
35.2.1.1 Confusional Arousal
35.2.1.2 Sleepwalking
35.2.1.3 Sleep Terror (Pavor Nocturnus)
35.2.2 PSG Features of NREM Parasomnias
35.2.3 REM Parasomnias
35.2.3.1 REM Behavior Disorder
35.3 Sleep-Related Movement Disorders
35.3.1 Restless Legs Syndrome and Periodic Limb Movements
35.3.2 Propriospinal Myoclonus at Sleep Onset
35.3.3 Sleep-Related Bruxism
35.4 Epilepsy
35.4.1 Impact of NREM and REM Sleep
35.4.2 CAP and Epilepsy
35.4.3 Sleep-Related Hypermotor Epilepsy
35.5 Hypersomnia of Central Origin
35.5.1 Narcolepsy Types 1 and 2
35.5.2 Objective Findings
35.6 Sleep-Related Breathing Disorders
35.6.1 Obstructive Sleep Apnea
35.6.2 Central Sleep Apnea Syndromes
35.7 Conclusions
References
36: Traumatic Brain Injury
36.1 Introduction
36.2 EEG in the Acute Post-traumatic Phase
36.3 EEG in the Chronic Post-traumatic Phase
36.4 Breach Effect
36.5 Post-traumatic Epilepsy
References
37: Cerebral Tumors
37.1 The Role of EEG in Brain Tumors
37.2 EEG Patterns: Correlation with Site and Type of Brain Tumors
37.2.1 Cortical Tumors: Focus on Dysembryoplastic Neuro Ectodermal Tumors
37.2.2 Subcortical Tumors: Focus on Hypothalamic Hamartoma
37.2.3 Extra-axial Tumors: Focus on Meningioma
37.3 Tumor-Related Epilepsy: Neurophysiological Basis and Considerations
37.4 EEG After Brain Surgery
References
38: Cerebrovascular Diseases
38.1 Cerebral Blood Flow (CBF) and Electric Cortical Activity During Cerebral Ischemia
38.2 Acute Ischemic Stroke
38.3 Intraparenchymal Hemorrhage
38.4 Subarachnoid Hemorrhage
38.5 Subdural Hematoma
38.6 Other Cerebrovascular Diseases
References
39: Cerebral Infectious Diseases
39.1 Infectious Meningitis
39.1.1 Bacterial Meningitis
39.1.2 Viral Meningitis
39.2 Infectious Encephalitis
39.3 Prion Diseases
39.3.1 Sporadic Creutzfeldt–Jakob Disease (sCJD)
39.3.2 Genetic CJD (gCJD)
39.3.2.1 Variant Creutzfeldt-Jakob Disease (vCJD)
39.3.2.2 Iatrogenic CJD (iCJD)
39.4 Neurosyphilis
39.5 HIV-Related CNS Diseases
39.6 Brain Abscess and Subdural Empyema
39.7 Parasitic Brain Infections
39.7.1 Neurotoxoplasmosis
39.7.2 Neurocysticercosis
39.7.3 Neurotoxocariasis
39.7.4 Cerebral Cystic Echinococcosis (Cystic Hydatidosis)
39.7.5 Trypanosomiasis
39.7.6 Cerebral Malaria
References
40: Autoimmune and Inflammatory Encephalopathies
40.1 Autoimmune Encephalitides
40.1.1 Anti-intracellular Neuronal Antigen Encephalitides
40.1.2 Anti-cell-Surface Neuronal Antigen Encephalitides
40.1.2.1 Anti-NMDAR Encephalitis
40.1.2.2 Anti-VGKC-Complex Encephalitides: Anti-LGI1 and Anti-CASPR2 Encephalitis
Anti-LGI1 Encephalitis
Anti-CASPR2 Encephalitis
40.1.2.3 Anti-AMPAR Encephalitis
40.1.2.4 Anti-GABAB Receptor Encephalitis
40.1.2.5 Anti-GABAA Receptor Encephalitis
40.1.3 Hashimoto Encephalopathy or Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis
40.2 Inflammatory Encephalopathies
40.2.1 Rasmussen Encephalitis
40.2.2 Multiple Sclerosis
40.2.3 Primary CNS Vasculitis
40.2.4 Systemic Inflammatory Diseases: Neuropsychiatric Systemic Lupus Erythematosus, Neuro-Behçet’s Disease, and Neurosarcoidosis
40.2.4.1 Neuropsychiatric Systemic Lupus Erythematosus
40.2.4.2 Neuro-Behçet’s Disease
40.2.4.3 Neurosarcoidosis
40.3 Status Epilepticus in Autoimmune/Inflammatory Encephalopathies
40.3.1 New-Onset Refractory Status Epilepticus and Febrile Illness-Related Epilepsy Syndrome
References
41: Aging and Degenerative Disorders
41.1 EEG Changes in the Elderly
41.2 Use and Advantages of the EEG Recording in the Elderly
41.3 Dementia Syndromes
41.3.1 Alzheimer’s Disease
41.3.2 Dementia with Lewy Bodies
41.3.3 Frontotemporal Dementia
41.4 Multi-infarct Dementia
41.4.1 Subcortical Dementia
References
42: Systemic and Dismetabolic Disorders
42.1 Introduction
42.2 Liver Disease
42.3 Renal Disease
42.4 Cardiorespiratory Disease
42.5 Disorders of Glucose Metabolism
42.5.1 Hypoglycemia
42.5.2 Hyperglycemia
42.6 Electrolyte Disturbances
42.6.1 Hypocalcemia
42.6.2 Hypercalcemia
42.6.3 Hyponatremia
42.7 Thyroid Disorders
42.7.1 Hyperthyroidism
42.7.2 Hypothyroidism
42.7.3 Hashimoto Encephalopathy
42.8 Other Hormonal Disorders
42.8.1 Hypercortisolism and Cushing’s Syndrome
42.8.2 Hypocortisolism
42.8.3 Hypopituitarism and Hyperpituitarism
42.9 Eclampsia
42.10 Acute Porphyria
References
43: Migraine
43.1 Migraine and the Role of EEG
43.1.1 Interictal EEG Abnormalities
43.1.1.1 Background Activity Abnormalities
43.1.1.2 Intermittent Photic Stimulation-Induced Abnormalities
43.1.1.3 HV-Induced Abnormalities
43.1.1.4 Epileptiform Abnormalities
43.1.2 Ictal EEG Abnormalities
43.1.3 Quantitative EEG (qEEG)
43.2 Migraine and Epilepsy
References
44: Psychiatric Disorders
44.1 Depressive Disorders
44.2 Bipolar and Related Disorders
44.3 Anxiety Disorders
44.4 Schizophrenia Spectrum and Other Psychotic Disorders
44.5 Attention-Deficit/Hyperactivity Disorder (ADHD)
44.6 Autism Spectrum Disorder (ASD)
References
45: Effects on EEG of Drugs and Toxic Substances
45.1 Pharmaco-Electroencephalography: History, Methodology, and Basic Principles
45.2 Effects of Drugs on EEG
45.2.1 Antiepileptic Drugs (AEDs)
45.2.1.1 Effects of AEDs on Background Activity
45.2.1.2 Effects of AEDs on Ictal and Interictal Epileptiform Activity
45.2.2 Anxiolytic Drugs
45.2.3 Antidepressants
45.2.4 Antipsychotics
45.2.5 Anesthetics
45.2.5.1 Propofol
45.2.5.2 Dexmedetomidine
45.2.5.3 Ketamine
45.2.6 Recreational Drugs and Toxic Substances
45.2.6.1 Cannabinoids
45.2.6.2 Psychostimulant Substances
45.2.6.3 Ethanol
45.2.7 Antibiotics
45.2.7.1 Penicillins
45.2.7.2 Cephalosporins
45.2.7.3 Carbapenems
45.2.7.4 Fluoroquinolones
References
46: Disorders of Consciousness
46.1 Anatomo-Pathophysiology of Disorders of Consciousness
46.2 Coma, Vegetative State, and Minimally Conscious State
46.3 Differential Diagnosis Among Consciousness Disorders
46.4 Clinical Examination of Comatose Patients
46.5 Neurobehavioural Rating Scales
46.6 EEG Patterns in Coma
46.6.1 Background Activity
46.6.2 EEG Reactivity
46.6.3 Peculiar Coma EEG Patterns
46.6.3.1 Periodic and Rhythmic Patterns: Epileptiform Activity
46.6.3.2 Spindle Coma and Beta Coma
46.6.3.3 Alpha, Alpha-Theta, and Theta Coma Patterns
46.6.3.4 Burst-Attenuation and Burst-Suppression Patterns
46.6.3.5 Electrocerebral Inactivity
46.7 EEG Patterns in Vegetative State and Minimally Conscious State
46.8 EEG in Coma Prognosis
References
47: Brain Death
47.1 History of Brain Death Determination
47.2 Clinical Diagnosis of Brain Death
47.3 Ancillary Tests
47.3.1 EEG
47.3.1.1 Technical Standards for EEG Recording in Brain Death
47.3.2 Evoked Potentials
47.3.3 Assessment of Cerebral Blood Flow
47.3.3.1 Conventional Four-Vessel Angiography
47.3.3.2 Computed Tomography Angiography (CTA) and CT Perfusion
47.3.3.3 Magnetic Resonance Angiography (MRA) and MR Perfusion
47.3.3.4 Single-Photon Emission Computed Tomography (SPECT)
47.3.3.5 Transcranial Doppler
47.4 Pediatric Brain Death Determination
47.5 Brain Death Worldwide
47.6 Legal Aspects of Brain Death Determination in Italy
47.6.1 Modalities for the Execution of EEG
47.6.2 Donation of Organs in Italy
References
48: Neuromonitoring and Emergency EEG
48.1 Intraoperative EEG monitoring
48.1.1 EEG Monitoring During Carotid Endarterectomy
48.1.2 EEG Monitoring in Cardiothoracic Surgery
48.2 EEG Monitoring in ICU
48.2.1 Continuous EEG (cEEG)
48.3 Emergency EEG (eEEG)
References
EEG Glossary
EEG Reporting
Introduction
EEG Description
Interpretation
Impression
Clinical Correlation
The Standardized Computer-Based Organized Reporting of EEG (SCORE)
References