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Clinical Neurophysiology, Third Edition will continue the tradition of the previous two volumes by providing a didactic, yet accessible, presentation of electrophysiology in three sections that is of use to both the clinician and the researcher. The first section describes the analysis of electrophysiological waveforms. Section two describes the various methods and techniques of electrophysiological testing. The third section, although short in appearance, has recommendations of symptom complexes and disease entities using electroencephalography, evoked potentials, and nerve conduction studies.

Arvustused

This is an excellent addition to the field. It provides good background on the neurophysiological concepts that are clinically applicable, and focuses more on the theory and interpretation of tests...the graphics are excellent and help to visually get across important teaching points. Jasper R. Daube MD & Devon I. Rubin MD

Contributors xxv
SECTION 1 BASIC NEUROPHYSIOLOGY AND AN INTRODUCTION TO ANALYSIS OF ELECTROPHYSIOLOGIC WAVEFORMS
Electricity and Electronics for Clinical Neurophysiology
5(16)
Terrence D. Lagerlund
Basic Principles and Definitions in Electricity
5(2)
Circuit Analysis
7(2)
Resistive-Capacitive and Resistive-Inductive Circuits
9(1)
Circuits Containing Inductors and Capacitors
10(4)
Filter Circuits
14(2)
Transistors and Amplifiers
16(5)
Electric Safety in the Laboratory and Hospital
21(12)
Terrence D. Lagerlund
Introduction
21(1)
Electric Power Distribution Systems
21(1)
Electric Shock
22(3)
Leakage Current
25(2)
Electric Safety Principles and Implementation
27(3)
Electric Stimulation Safety
30(3)
Volume Conduction
33(20)
Terrence D. Lagerlund
Devon I. Rubin
Jasper R. Daube
Principles
33(1)
Sources of Electrical Potentials
34(4)
Current Sources: Monopoles, Dipoles, and Quadrupoles
38(3)
Volume Conduction Theory: Electric Properties in Volume Conductors
41(2)
Applications of Volume Conduction Principles
43(10)
Digital Signal Processing
53(16)
Terrence D. Lagerlund
Digital Computers in Clinical Neurophysiology
53(3)
Digitization
56(3)
Common Uses of Digital Processing
59(1)
Averaging
60(2)
Digital Filtering
62(1)
Time and Frequency Domain Analysis
63(6)
Basics of Neurophysiology
69(28)
Jasper R. Daube
Squire M. Stead
Introduction
69(1)
Cell Membrane
69(7)
Resting Potential
76(2)
Local Potentials
78(4)
Action Potentials
82(6)
Synaptic Transmission
88(5)
Clinical Correlations
93(4)
Electrophysiologic Generators in Clinical Neurophysiology
97(6)
Terrence D. Lagerlund
Structural Generators
97(6)
Waveforms and Artifacts
103(16)
Jasper R. Daube
Introduction
103(1)
Continuous Waveforms
103(3)
Event Recording
106(2)
Combinations of Continuous Waveforms and Events
108(1)
Waveform Alterations
108(1)
Physiologic Alteration of Waveforms
108(3)
Artifactual Waveforms
111(8)
SECTION 2 ELECTROPHYSIOLOGIC ASSESSMENT OF NEURAL FUNCTION
Assessment of Cortical Function
Electroencephalography: Adult, Normal, and Benign Variants
119(18)
Barbara F. Westmoreland
Introduction
119(1)
Recording the Electroencephalogram
119(1)
Display of Eeg Activity
119(1)
Activation Procedures
120(3)
Artifacts
123(1)
Normal Eeg Activity of Adults
124(6)
Benign Variants
130(7)
Epileptiform Activity
137(14)
Joseph F. Drazkowski
Introduction and Overviwe of Epileptiform Activity
137(1)
Specific Focal Interictal Discharges
138(3)
Generalized Epileptiform Patterns
141(4)
Ictal Discharges
145(3)
Epileptiform Activity with a Potential Seizure Association
148(3)
Adult Eeg: Abnormal Nonepileptiform Activity
151(16)
Barbara F. Westmoreland
Introduction
151(1)
Types of Eeg Abnormalities
152(2)
Focal Intracranial Processes Causing Eeg Abnormalities
154(5)
Electroencephalographic Manifestations of Diffuse Disorders
159(5)
Evaluation for Suspected Brain Death
164(3)
Electroencephalography: Electroencephalograms of Infants and Children
167(20)
Barbara F. Westmoreland
Introduction
167(1)
Neonatal Eeg Patterns
168(5)
Developmental Changes During Infancy, Childhood, and Adolescence
173(2)
Benign Variants in Children
175(1)
Abnormalities
175(12)
Ambulatory Electroencephalography
187(6)
Jeffrey R. Buchhalter
Introduction
187(1)
Indications
187(1)
Technology
188(1)
Clinical Applications
189(4)
Prolonged Video Electroencephalography
193(10)
Cheolsu Shin
Introduction
193(1)
Equipment
194(1)
Clinical Application
195(8)
Electroencephalographic Special Studies
203(12)
Gregory A. Worrell
Terrence D. Lagerlund
Introduction
203(1)
Quantitative Methods of Electroencephalographic Analysis
203(8)
Magnetoencephalography
211(4)
Electroencephalography in the Surgical Evaluation of Epilepsy
215(14)
Joseph F. Drazkowski
Background
215(1)
Presurgical Selection and Evaluation
216(2)
Routine Eeg in the Surgical Evaluation of Patients with Seizures
218(1)
Preoperative Video-Eeg Monitoring
218(1)
Presurgical Evaluation with Continuous or Chronic Intracranial Monitoring
219(4)
Intraoperative Electrocorticography
223(6)
Movement-Related Cortical Potentials and Event-Related Potentials
229(10)
Virgilio Gerald H. Evidente
John N. Caviness
Movement-Related Cortical Potentials
229(3)
Event-Related Potentials
232(7)
Sensory Pathways
Sensory Nerve Action Potentials
239(18)
Eric J. Sorenson
Introduction
239(1)
Pathophysiology of Snaps
240(3)
Methods of Study of Snaps
243(4)
Measurements
247(1)
Technical Factors
248(3)
Planning the Study and Findings in Diseases
251(6)
Somatosensory Evoked Potentials
257(24)
Jonathan L. Carter
J. Clarke Stevens
Introduction
257(1)
Generators and Origin of Seps
258(1)
Methods
258(2)
Recording
260(8)
Localization
268(1)
Clinical Applications
269(12)
Brain Stem Auditory Evoked Potentials in Central Disorders
281(14)
Jonathan L. Carter
Introduction
281(2)
Auditory Anatomy and Physiology
283(1)
Generators of the Brain Stem Auditory Evoked Potentials
283(1)
Brain Stem Auditory Evoked Potentials: Methods
284(2)
Factors Affecting the Baep Response
286(1)
Interpretation of Baeps
287(1)
Clinical Applications
288(7)
Audiogram, Acoustic Reflexes, and Evoked Otoacoustic Emissions
295(10)
Christopher D. Bauch
Wayne O. Olsen
Introduction
295(1)
Audiogram
296(2)
Acoustic Reflex
298(3)
Evoked Otoacoustic Emissions
301(2)
Applications
303(2)
Brain Stem Auditory Evoked Potentials in Peripheral Acoustic Disorders
305(6)
Christopher D. Bauch
Introduction
305(1)
Stimuli
306(1)
Electrodes
306(1)
Interpretation
306(2)
Applications
308(3)
Visual Evoked Potentials
311(16)
Jonathan L. Carter
Introduction
311(1)
Visual System Anatomy and Physiology
312(1)
Visual Evoked Potentials: Methods
312(2)
Factors Affecting the Vep Response
314(3)
Interpretation of Veps
317(1)
Localization of Visual System Lesions
318(9)
Motor Pathways
Compound Muscle Action Potentials
327(42)
Jomes C. Watson
Jasper R. Daube
Introduction
327(1)
General Clinical Applications
328(1)
Recording Cmaps
329(3)
Stimulation
332(2)
Cmap Measurements
334(4)
Fwaves
338(4)
Axon Reflexes (A Waves)
342(1)
Physiologic Variables Affecting the Cmap
343(1)
Cmap Changes in Disease
344(2)
Findings in Peripheral Nerve Disorders
346(23)
Assessing the Neuromuscular Junction with Repetitive Stimulation Studies
369(16)
Andrea J. Boon
Introduction
369(1)
Anatomy and Physiology of the Neuromuscular Junction
370(2)
Technique
372(5)
Criteria of Abnormality
377(1)
Rapid Rates of Stimulation
378(1)
Selection of Nerve-Muscle Combinations
379(1)
Clinical Correlations
380(5)
Motor Evoked Potentials
385(18)
Jeffrey A. Strommen
Introduction
385(1)
Technique
386(6)
Mep Pharmacology
392(1)
Applications
393(2)
Contraindications and Risks
395(8)
Assessing the Motor Unit
Assessing the Motor Unit with Needle Electromyography
403(48)
Devon I. Rubin
Introduction
404(1)
Knowledge Base of Needle Emg
404(1)
Technique of Needle Examination
405(1)
Conducting the Needle Examination
405(4)
Potential Complications During Needle Examination
409(3)
Emg Signal Analysis
412(1)
Needle Electrode Characteristics
412(1)
Skills of Emg Waveform Recognition
413(2)
Origin of Emg Potentials
415(2)
Normal Emg Activity
417(7)
Abnormal Spontaneous Electric Activity
424(13)
Abnormal Electrical Activity---Voluntary Mups
437(8)
Abnormal Electrical Activity---Disorders of Central Control
445(1)
Patterns of Abnormalities
445(6)
Quantitative Electromyography
451(24)
Benn E. Smith
Introduction
451(2)
Characteristics of the Motor Unit Potential
453(1)
Characteristics of the Recording Equipment
454(2)
Properties of Mups Evaluated Using Standard Electrodes
456(4)
Properties of Mups Measurable Only with Special Electrodes
460(2)
Quantitative Analysis of Single Mups
462(5)
Properties of Interference Pattern and Methods of Interference Pattern Analysis
467(2)
Turns and Amplitude Analysis of the Interference Pattern
469(2)
Power-Spectrum Analysis
471(1)
Automated Methods of Analysis of Spontaneous Activity
472(3)
Single Fiber Electromyography
475(18)
C. Michel Harper, Jr.
Introduction
475(2)
Technique
477(6)
Pitfalls of Sfemg
483(3)
Clinical Applications of Sfemg
486(7)
Quantitative Motor Unit Number Estimates
493(26)
Jasper R. Daube
Introduction
493(2)
Mune by Standard Emg
495(1)
Mune by Standard Motor Ncs
496(1)
Quantitative Mune
497(13)
Clinical Applications
510(9)
Reflexes and Central Motor Control
H Reflexes
519(10)
Ruple S. Laughlin
Introduction
519(1)
Physiologic Basis
519(2)
Technique
521(3)
Pediatric H Reflexes
524(1)
Clinical Applications
524(5)
Cranial Reflexes and Related Techniques
529(14)
Benn E. Smith
Introduction
529(1)
Blink Reflex
530(5)
Lateral Spread of the Facial Nerve Response: Assessment of Facial Synkinesis and Hemifacial Spasm
535(2)
Jaw Jerk (Masseter Reflex)
537(1)
Masseter Inhibitory Reflex
538(2)
Great Auricular Sensory Nerve Conduction Studies
540(1)
Trigeminal Contact Heat Evoked Potential Stimulator Studies
540(3)
Long Latency Reflexes and the Silent Period
543(8)
John N. Caviness
Introduction
543(1)
Long Latency Reflexes
543(3)
The Silent Period
546(5)
Movement Disorders
551(24)
John N. Caviness
Introduction
551(1)
Techniques
552(1)
Eeg
553(1)
Surface Emg: Normal Patterns
554(1)
Tremor
554(5)
Myoclonus
559(9)
Psychogenic Jerks
568(1)
Startle Disorders
568(1)
Periodic Limb Movements of Sleep
568(1)
Dystonia
569(2)
Tics. Chorea, and Athetosis
571(1)
Voluntary Movement Abnormalities
571(4)
Vertigo and Balance
575(42)
David A. Zapala
Robert H. Brey
Introduction
575(7)
Laboratory Examination: Vor-Based Measures
582(17)
Laboratory Examination: Var-Based Measures
599(8)
Clinical Applications of Vestibular Testing: Assessing Sensorineural Syndromes of the Labyrinth
607(3)
Vestibular Rehabilitation
610(7)
Autonomic Function
Autonomic Physiology
617(12)
William P. Cheshire, Jr.
Introduction
617(1)
Symptoms and Diseases
617(2)
General Organization of the Autonomic System
619(2)
Sympathetic Function
621(1)
Sympathetic Innervation of the Skin
622(1)
Muscle Sympathetic Activity
623(1)
Autonomic Control of Heart Rate
624(1)
Cardiovascular Reflexes
624(2)
Maintenance of Postural Normotension
626(3)
Quantitative Sudomotor Axon Reflex and Related Tests
629(8)
Phillip A. Low
Introduction
629(1)
Laboratory Evaluation of Autonomic Function
629(1)
Quantitative Sudomotor Axon Reflex Test
630(4)
Imprint Methods of Sweat Measurement
634(3)
Evaluation of Adrenergic Function
637(8)
Phillip A. Low
Introduction
637(1)
Skin Vasomotor Reflexes
637(8)
Thermoregulatory Sweat Test
645(16)
Robert D. Fealey
Introduction
645(1)
Role of Thermoregulatory Sweat Testing: Clinical Syndromes and Problems Evaluated
646(4)
Method
650(3)
Thermoregulatory Sweat Distribution
653(3)
Reporting Results
656(1)
Difficulties and Pitfalls in Interpretation
657(4)
Cardiovagal Reflexes
661(16)
William P. Cheshire, Jr.
Introduction
661(1)
Heart Rate Response to Deep Breathing
662(3)
The Valsalva Maneuver
665(5)
Cardiovagal Scoring
670(1)
Power Spectrum Analysis
670(1)
Heart Rate Response to Standing
671(1)
Other Tests of Cardiovagal Function
672(5)
Electrophysiology of Pain
677(20)
Rose M. Dotson
Paola Sandroni
Introduction
677(1)
Quantitative Sensory Test
678(3)
Autonomic Tests
681(2)
Microneurography
683(1)
Laser Evoked Potentials
684(4)
Contact Heat Evoked Potentials
688(9)
Sleep and Consciousness
Assessment of Sleep and Sleep Disorders
697(30)
Michael H. Silber
Cameron D. Harris
Peter J. Hauri
Introduction
697(1)
Techniques Used in Studying Sleep
698(8)
Staging of Sleep
706(6)
Assessing Respiration During Sleep
712(3)
Assessing Movements in Sleep
715(3)
Assessing Other Physiologic Variables
718(1)
Performance of a Sleep Study
718(1)
Assessing Sleep Disorders
719(8)
Intraoperative Monitoring
Cerebral Function Monitoring
727(12)
Elson L. So
Frank W. Sharbrough
Introduction
727(1)
Technical Factors in Intraoperative Eeg Monitoring
727(4)
Effects of Anesthesia on Electroencephalography Symmetrical Eeg Patterns During Anesthesia
731(1)
Preoperative Focal Abnormalities Seen with Anesthesia
732(1)
Clinical Applications
733(1)
Eeg Changes During Carotid Endarterectomy
733(2)
Sep Recording During Carotid Endarterectomy
735(1)
Other Monitoring Techniques During Carotid Endarterectomy
735(1)
Eeg Monitoring During Cardiac Surgery
736(1)
Bispectral Analysis of Eeg for Monitoring Depth of Anesthesia
736(1)
Eeg Monitoring for Epilepsy Surgery
736(3)
Brain Stem and Cranial Nerve Monitoring
739(12)
Brian A. Crum
Introduction
739(1)
Methods
740(3)
Applications
743(8)
Spinal Cord Monitoring
751(26)
Jeffrey A. Strommen
Introduction
751(1)
General Principles of Intraoperative Monitoring
752(1)
Equipment and Electrical Safety
753(1)
Monitoring Methods---Somatosensory Evoked Potentials
754(6)
Motor Evoked Potentials
760(5)
Electromyography and Nerve Conduction Studies
765(3)
Types of Spinal Surgeries
768(9)
Peripheral Nervous System Monitoring
777(14)
C. Michel Harper, Jr.
Introduction
777(1)
Methods
778(2)
Applications
780(11)
SECTION 3 APPLICATIONS OF CLINICAL NEUROPHYSIOLOGY: ASSESSING SYMPTOM COMPLEXES AND DISEASE ENTITIES
Assessing Central Nervous System Symptoms
791(10)
Elson L. So
Introduction
791(1)
Assessment of Motor Symptoms of Central Origin
791(1)
Assessment of Sensory Symptoms of Central Origin
792(1)
Assessing Impairment of Consciousness and Cognition
792(1)
Assessing Impairment of Visceral Function and Sleep
792(1)
Identifying Disease Types
793(1)
Prognosis
793(1)
Assessing Clinical Disorders with Eeg
793(8)
Application of Clinical Neurophysiology: Assessing Peripheral Neuromuscular Symptom Complexes
801(38)
Devon I. Rubin
Jasper R. Daube
Clinical Neurophysiology in the Assessment of Peripheral Nervous System Disorders
802(4)
Assessing Clinical Disorders: Assessment with Emg and Ncs
806(1)
Radiculopathies
806(2)
Common Focal Mononeuropathies
808(2)
Peripheral Neuropathy
810(7)
Brachial Plexopathy
817(5)
Generalized Weakness
822(1)
Myopathy
823(4)
Myalgias, Muscle Stiffness, and Episodic Muscle Weakness
827(1)
Nmj Disorders
827(2)
Polyradiculopathy
829(1)
Motor Neuron Disease
830(1)
Facial Weakness
831(1)
Anomalous Innervation
831(4)
Unexpected Findings on Nerve Conduction Studies: Cause and Action
835(4)
Glossary of Electrophysiologic Terms 839(30)
Index 869
Jasper R. Daube, MD, Professor of Neurology, Mayo Clinic, College of Minnesota, Rochester, MN

Devin I. Rubin, MD, Professor of Neurology, Mayo Clinic, Jacksonville, FL