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Standard Electroencephalography in Clinical Psychiatry: A Practical Handbook

ISBN: 978-0-470-74782-7
198 pages
April 2011
Standard Electroencephalography in Clinical Psychiatry: A Practical Handbook (047074782X) cover image
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 and signal analysis, with plentiful illustrations of the most frequent biological or technical artefacts. Normal EEG patterns and waveforms for easy reference are clearly presented, before the detailed description of abnormal patterns.

With the basic information in hand, the reader progresses to an account of the role of EEG in the diagnostic work up in psychiatry, covering nonconvulsive status epilepticus, frontal lobe seizures and non-epileptic seizures. The clinical application of EEG in both childhood and adult disorders follows, including many case vignettes. The effects of psychotropic drugs on EEG are highlighted.

The book closes with a discussion of currently available certification venues for Clinical Neurophysiology along with limitations of each venue. It calls for the development of training guidelines and certification processes specific to Psychiatric Electrophysiology.

The material is clearly presented throughout, with plenty of figures, tables with summaries of relevant findings, flow diagrams for diagnostic work-up, boxes with learning points, and short lists of key references.

We fully expect the book will become the standard teaching source for psychiatry residents and fellows, as well as a useful resource for practising psychiatrists and clinical psychologists.

Praise for the book:

"This distinguished group of editors has put together chapters that represent an excellent practical handbook on electroencephalography in clinical psychiatry, now a very important topic. I highly recommend it not only to psychiatrists, but also to anyone interested in neuroscience."
John R. Hughes, DM (Oxon), MD, PhD, Professor of Neurology, University of Illinois Medical Center, at Chicago, Illinois, USA

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List of Contributors.

Preface.

1 Historical Review of Electroencephalography in Psychiatry (Nash Boutros).

Introduction.

The early pre-clinical era.

Early history of human electroencephalography.

Electroencephalography in psychiatry today.

References.

2 Physiologic Basis of the EEG Signal (Paola Bucci and Silvana Galderisi).

Membrane potentials.

Excitatory and inhibitory postsynaptic potentials.

Nonsynaptic intercellular events contributing to the EEG signal.

Factors determining polarity and other characteristics of the surface EEG waveforms.

Brain structures involved in the genesis of EEG rhythms.

References.

3 EEG Recording and Analysis (Oliver Pogarell).

Techniques and technical background.

References.

4 Normal EEG Patterns and Waveforms (Paola Bucci, Armida Mucci and Silvana Galderisi).

Introduction.

Normal EEG patterns in the waking adult.

References.

5 Abnormal Patterns (Oliver Pogarell).

Introduction.

Detection of artefacts.

Abnormal patterns.

Focal alterations.

References.

6 The Role of EEG in the Diagnostic Work Up in Psychiatry: Nonconvulsive Status Epilepticus, Frontal Lobe Seizures, Non-Epileptic Seizures (Silvana Riggio).

Nonconvulsive status.

Psychogenic non-epileptic seizures.

Frontal lobe seizures.

References.

7 EEG in Childhood Psychiatric Disorders (Mary W. Roberts and Nash Boutros).

Introduction.

Attention deficit disorder.

Autistic spectrum disorders.

References.

8 EEG in Psychoses, Mood Disorders and Catatonia (Nash Boutros, Silvana Galderisi, Oliver Pogarell and Felix Segmiller).

Introduction.

EEG in psychoses.

EEG in mood disorders.

EEG findings in catatonia.

References.

9 Standard EEG in Personality and Anxiety Disorders (Nash Boutros).

Introduction.

EEG in aggression and impulse dyscontrol.

Panic attacks.

Borderline personality disorder.

References.

10 EEG in Delirium and Dementia (Sophia Wang and Silvana Riggio).

Introduction: Epidemiology of delirium and dementia.

Clinical diagnosis in delirium.

EEG work up in delirium.

Metabolic causes of delirium.

Infectious causes of delirium.

Clinical diagnosis and EEG work up in dementia.

Conclusion.

References.

11 Effects of Psychotropic Drugs on EEG (Silvana Galderisi and Armida Mucci).

Introduction.

The role of EEG assessment of drug-induced CNS toxicity in psychiatric patients.

Antipsychotic drugs.

Lithium.

Other mood stabilisers.

Anxiolytics.

Antidepressants.

Recreational drugs.

Case vignette.

References.

12 Certification and Training in EEG and Clinical Neurophysiology (Nash Boutros and Silvana Galderisi).

Clinical neurophysiology board certification.

Index.

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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.

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"This handbook, written and edited by experts in the field, is a welcome addition to the psychiatric literature. The only comparable book on this topic is EEG and Evoked Potentials in Psychiatry and Behavioral Neurology, Hughes and Wilson (Butterworth-Heinemann, 1983). This handbook is sort of an update of that classic." (Doody's, 7 October 2011)

"Whether such a curriculum is defined in your country or not the book is recommended to all psychiatrists and clinical psychologists working with diagnosis of patients. For psychiatric residents it is an easily accessible, handy yet sufficiently exhaustive introduction to EEG." (Acta Neuropsychiatrica, 2011)

"In summary, this book will most certainly be included in psychiatry curricula and will be a milestone of which Hans Berger will be proud." (Epilepsy & Behavior, 7 May 2011)

"The guide is readable and is useful for medical students, psychiatric residents and clinicians seeking to augment their clinical skills in managing complex psychiatric treatments. The book fills a need and is a reminder that brain physiology is the core component in understanding and treating the aberrant behaviors that fill psychiatric clinics." (Acta, 1 May 2011)

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