Clinical Electroencephalography - 2nd Edition - ISBN: 9788131252956, 9788131252963

Clinical Electroencephalography

2nd Edition

Authors: U.K. Misra J Kalita
Hardcover ISBN: 9788131252956
eBook ISBN: 9788131252963
Imprint: Elsevier India
Published Date: 5th October 2018
Page Count: 370

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Table of Contents

Preface to the Second Edition

Preface to the First Edition

Videos and Case Studies

1 Electroencephalography: A Historical Perspective

History of Epilepsy

Scientific Thinking

Biological Electricity

Spontaneous Activity from Animal Brain

Synthesis of Clinical and Experimental Studies

Cellular Anatomy – Neuron Doctrine

Experimental EEG

Human EEG

Digital EEG

2 Technical Aspects of EEG Recording and Reporting

EEG Recording

EEG Machine


Scalp Electrodes

Subdermal Electrodes

Clip Electrodes

Nasopharyngeal Electrode

Sphenoidal Electrode

Tympanic Electrode

Depth Electrodes

Cortical Electrode

Subdural Electrodes

Epidural Electrodes

Electrode Connection

Electrode Placement

Analogue EEG


EEG Filters

Ancillary EEG Controls

Individual Channel Control

Calibration Signal

Electrode Test Switch

Baseline Adjustment

Sensitivity Adjustment

Event Marker

Trace Restore

Output and Input Jacks

Writing System

Paper Transport

Electrical Safety

Derivation and Montage



Referential Montages

Bipolar Montages

Laplacian Montage

Selection of Montages

Display Conventions

Focus Localisation

Calibration of EEG Machine

Calibration Checks in Conventional EEG Machine

Routine Calibration


Digital EEG Machine


EEG Recording


Activation Procedures


Intermittent Photic Stimulation

Sleep as an Activation Procedure

Special Forms of Stimulus

Drug Activation

Drug Suppression Test

EEG Reporting

Frequency of Waveforms


3 Normal Electroencephalogram

Awake EEG

Alpha Rhythm

Beta Rhythm

Theta Rhythm

Miscellaneous Waveforms

Mu Rhythm

Lambda Rhythm

Sleep EEG

Drowsiness (Stage N1 Sleep)

Light Sleep (Stage N2)

Deep Sleep (Stage N3)

Very Deep Sleep (Stage IV NREM of R&K or Stage N3 of AASM)

REM Sleep (Stage R)

Arousal From Sleep

Normal EEG in Newborn

EEG Landmarks in Neonates


Hemispheric Synchrony

Beta–Delta Complexes

Temporal Theta Bursts

Frontal Sharp Waves

Reactivity to Stimulus

Differentiation Between Sleep and Awake EEG

Patterns of Questionable Significance

Features of Abnormality in EEG of Premature and Term Infants

EEG of Infants (2–12 Months)

EEG in Awake Stage

EEG Characteristics in Sleep

Non-REM Sleep

REM Sleep

EEG in Early Childhood

EEG in 12–36 Months

EEG in Preschool Age (3–5 Years)

EEG of Older Children (6–12 Years)

EEG in Adolescents (13–20 Years)

EEG in Old Age

4 Artefacts and Benign EEG Variants


Mechanical Artefacts

Environmental Electrical Interference

Instrumental Artefacts

Intravenous Drip Artefact

Respirator Artefact

Biological Artefacts

Eye Movement Artefacts

Cardiac and Respiratory Artefacts

Pulse Artefacts

Muscle Artefact

Glossokinetic Artefact

Movement Artefacts

Cutaneous Artefacts

Miscellaneous Artefacts

Benign EEG Variants

Rhythmic Activities

Rhythmic Temporal Theta Burst of Drowsiness or Psychomotor Variant Pattern

Subclinical Rhythmic Theta Discharges in Adults

Midline Theta Rhythm

Frontal Arousal Rhythm

Benign Epileptiform Variants

14–6 Hz Positive Bursts

Small Sharp Spikes

6 Hz Spike and Wave

Wicket Spikes

5 Epileptiform and Nonepileptiform Paroxysmal EEG Abnormalities

Interictal Epileptiform Paroxysmal Patterns


Sharp Waves

Polyspikes or Multiple Spikes

Runs of Rapid Spikes

Small Sharp Spikes

Spike and Slow Wave Complexes

Ictal Paroxysmal Patterns


Periodic and Quasiperiodic Discharges

Subacute Sclerosing Panencephalitis (SSPE)

Periodic Discharges in Creutzfeldt–Jakob Disease

Periodic Discharges in Herpes Simplex Encephalitis

Periodic Discharges in Acute Cerebral Anoxia

Periodic Lateralised Epileptiform


Nonepileptiform Paroxysmal EEG Abnormalities

Differentiation of Epileptiform Discharges From Nonepileptiform Benign Transients

Significance of Epileptiform Discharges

6 Electroencephalography in Epilepsy

Mechanism of Seizures

Initiation and Propagation




Seizure Termination



Mirror Focus

Genetic Susceptibility

Seizure Classification

Generalised Seizures

Generalised Tonic–Clonic Seizures

Atonic Seizures

Myoclonic Seizures

Absence Seizures (Petit Mal

Focal Seizure with Intact Awareness/Simple Partial Seizures

Focal Motor Seizure (Rolandic Motor Seizures)

Adversive or Versive or Ipsiversive or Contraversive Seizures


Scan to play (Video 1) Adversive seizure


Ictal Paralysis (Somatic Inhibitory Seizures)

Aphasic and Phonatory Seizures

Focal (Partial) Sensory Seizure

Visual, Auditory and Gustatory Seizures

Focal Seizure with Impaired Awareness/Complex Partial Seizures

Seizures Originating From Various Locations

Temporal Lobe Epilepsy

Frontal Lobe Epilepsy

Parietal Lobe Seizures

Occipital Lobe Seizure

Reflex Epilepsy

Photosensitivity and Television Epilepsy

Hot Water Epilepsy

Overview of Use of EEG in the Diagnosis of Epilepsies

7 Electroencephalography in Paediatric Practice

Technical Aspects

Normal Variation in EEG

EEG in Neonates

Abnormal Neonatal EEG

Abnormalities in Background Activity

Abnormalities in EEG Maturation

Ictal and Interictal EEG Discharge in Neonate

Assessment of Prognosis

Focal Abnormalities

Neonatal Seizures and Syndromes

Catastrophic Neonatal Epilepsy

Benign Neonatal Epilepsy Syndromes

Infantile Seizures and Epilepsy Syndromes

EEG Ictal Correlate

Infantile Epilepsy Syndromes


Scan to play (Video 2) Head drop in apatient with West syndrome


Benign and Malignant Epileptic Syndromes of Childhood

Benign Epilepsies of Childhood

Benign Partial Epilepsy of Childhood with Centrotemporal Spike (Benign Rolandic Epilepsy)

Benign Focal Epilepsy of Childhood\ with Occipital Spikes (Panayiotopoulos Syndrome)

Intermediate Syndromes Between Benign and Catastrophic Childhood Epilepsies

Childhood Absence Epilepsy

Other Absence Epilepsies

Cryptogenic Partial Seizures Starting in Childhood

Generalised Epilepsy with Febrile Seizure Plus (GEFS)

Catastrophic Epilepsies of Childhood

Continuous Spike Wave in Slow Sleep (CSWSS)

Landau–Kleffner Syndrome

Lennox–Gastaut Syndrome (LGS)


Scan to play (Video 3A and B) Multiple types of seizures


Myoclonic Astatic Epilepsy/Myoclonic Atonic Epilepsy/Doose Syndrome

Adolescent Seizures and Epilepsy Syndromes

Idiopathic (GENETIC) Generalised Epilepsy (GGE)

Juvenile Myoclonic Epilepsy

Generalised Epilepsy on Awakening (GTCSA)

Juvenile Absence Epilepsy

Progressive Myoclonic Epilepsy

Unverricht–Lundborg Disease (Baltic Myoclonus)

Lafora Body Disease

Myoclonic Epilepsy with Ragged Red Fibres (MERRF)

Neuronal Ceroid Lipofuscinosis (NCL)

Medial Temporal Lobe Epilepsy (MTLE)

Febrile Convulsions

Recommendation of Treatment of Febrile Convulsion

Nonepileptic Events in Children

Sandifer Syndrome

Benign Neonatal Myoclonus

Benign Myoclonus of Infancy

Shuddering Attacks

Spasmus Nutans

8 Electroencephalography in Status Epilepticus

Evolution of Definition of Status Epilepticus

Classification of Status Epilepticus

Generalised Convulsive Status Epilepticus


Myoclonic Status Epilepticus

Simple Partial (FOCAL) Status Epilepticus and Epilepsia Partialis Continua

Nonconvulsive Status Epilepticus

Complex Partial Status Epilepticus (Focal SE with Impaired Consciousness)

Absence Status Epilepticus

Drug-Induced Nonconvulsive Status Epilepticus

Electrical Se and Slow Wave Sleep

EEG Monitoring During Status Epilepticus

Prognostic Value of EEG in SE

9 Electroencephalography in Brain Tumours and Focal Brain Lesions

Abnormal Background Rhythm

Arrhythmic Delta Activity

Intermittent Rhythmic Slow Activity

Epileptiform Activity

Periodic Lateralised Epileptiform Discharges

Nonlocalising Abnormality

Role of Activation Procedures

EEG Changes in Brain Tumours

Cerebrovascular Diseases

Hypertensive Encephalopathy


Migraine and Epilepsy

10 Electroencephalography in Central Nervous System Infections and Infestations

Viral Infections

Herpes Simplex Encephalitis

Enterovirus Encephalitis

Arbovirus Encephalitis

Dengue Virus Infection

HIV Infection

Congenital Rubella Encephalitis

Progressive Rubella Encephalitis

Congenital Cytomegalovirus Disease

Subacute Sclerosing Panencephalitis


Scan to play (Video 4) Myoclonic jerks


Creutzfeldt–Jakob Disease


Scan to play (Video 5) Myoclonic jerks


Rasmussen Encephalitis


Scan to play (Video 6) Epilepsia partialis continua


Bacterial Infections

Scrub Typhus

Tuberculous Meningitis


Brain Abscess

Parasitic Infections

Cysticercosis and Echinococcosis


African Trypanosomiasis

Cerebral Malaria

Prenatal Infections

Autoimmune Encephalitis

11 Electroencephalography in Dementia and Degenerative Diseases

EEG in Delirium and Dementia

Acute Confusional State or Delirium


Alzheimer Disease

Diffuse Lewy Body Disease

Frontotemporal Dementia

Multi-Infarct Dementia (MID)

Huntington Disease

Parkinson Disease

Progressive Supranuclear Palsy

Normal Pressure Hydrocephalus

AIDS Dementia Complex

Alcoholic Dementia


EEG in Progressive Metabolic Degenerative and Hereditary Encephalopathies

Lysosomal Storage Disease

GM2 Gangliosidosis

GM1 Gangliosidosis

Gaucher Disease

Farber Disease


Schilder Disease


Peroxisomal Disorders


Zellweger Syndrome

Progressive Familial Myoclonic Epilepsies


Tuberous Sclerosis

Sturge–Weber Syndrome

Incontinentia Pigmenti

12 Electroencephalography in Metabolic Disorders

Hepatic Encephalopathy

Reye Syndrome

Wilson Disease

Renal Diseases

Electrolyte Imbalance

Glucose Metabolism


Vitamin-Deficiency Syndromes

Postsurgical Encephalopathies


13 Electroencephalography in Coma and Brain Death

Pathophysiology of Coma

EEG Evaluation of Coma

EEG Abnormalities in Coma

Alternating Pattern

Continuous High-Voltage Delta Activity

Periodic Pattern

Periodic Spikes

Epileptiform Activities

Low-Voltage Slow Unreactive EEG

Unilateral, Lateralised or Focal Changes

Triphasic Waves

Sleep Pattern in Coma

Alpha Pattern Coma

Anoxia and Anoxic Coma

EEG Changes in Anoxia and Anoxic Coma

Brain Death and Criteria for Diagnosis

Complicating Condition

EEG in Brain Death

Role of EEG in Brain Death

14 Electroencephalography in Psychiatric Diseases

Reason for EEG Referral

Schizophrenia and Other

Psychotic Disorders

Mood Disorders

Anxiety Disorders

Obsessive-Compulsive Disorders

Somatoform Disorders

Dissociative Disorders

Sexual and General

Identity Disorders

Eating Disorders

Nonclassifiable Impulse Control Disorders

Personality Disorders

EEG in Pervasive Developmental Disorders

Conduct Disorders

Tourette Syndrome

Delirium and Cognitive Disorders

Substance-Related Disorders


Antipsychotic Drugs


CNS Stimulants

Antiepileptic Drugs

15 Electroencephalography in Obstetric Disorders

Effects of Pregnancy on Epilepsy

Metabolic Changes

Stress and Anxiety

Preeclampsia and Eclampsia

Stroke Related To Pregnancy and Puerperium

Status Epilepticus in Pregnancy

16 Presurgical Evaluation of Epilepsy


Defining Drug-Resistant Epilepsy

Surgically Remediable Epilepsy Syndromes

Concept of Presurgical Evaluation

Comprehensive Epilepsy Care Facility

Process of Presurgical Evaluation

Clinical Evaluation

Long-Term Video EEG Monitoring


Scan to play (Video 7: Case 1) Semiology of classical left mesial temporal lobe seizure


Scan to play (Video 8: Case 2) Asymmetrical tonic seizure of left mesial frontal (supplementary motor area) origin


Scan to play (Video 9: Case 3) Bilateral tonic seizure of left mesial frontal origin


Scan to play (Video 10: Case 4) Extratemporal seizure of uncertain lateralization and localization


Structural Imaging

Functional MRI and Simultaneous

EEG–Functional MRI

Single Photon Emission Computed Tomography and Positron Emission Tomography

Magnetoencephalography and Magnetic Source Imaging

EEG Source Imaging

Neuropsychological Evaluation and Wada Test

Intracranial Monitoring

Presurgical Evaluation in Resource-Poor Settings


17 Overview of EEG: Use and Abuse

Diagnosis of Epilepsy

Diagnostic Specificity

EEG in Differential Diagnosis of Seizures


Scan to play (Video 11) Semiology of psychogenic nonepileptic seizure induced by suggestion


EEG in Special Situations

Severity of Epilepsy and Assessment of Therapy

EEG in Drug Withdrawal

Presurgical Evaluation

Febrile Convulsions

Psychiatric Disorder

Transient Cognitive Impairment (TCI) During Epileptiform Discharges

Driving and Flying

18 Laboratory Evaluation of Sleep Disorders


Development of Polysomnography

Anatomy and Physiology of Sleep


Sleep Staging

Sleep Architecture (Hypnogram)

Physiological Assessment

Respiratory Scoring

Periodic Limb Movement Scoring

Additional Recordings

Indication of PSG

Artefacts and Pitfalls of PSG

Running the Test

Additional Sleep Studies

Multiple Sleep Latency Test

Maintenance of Wakefulness Test

Suggested Immobilisation Test


Clinical Application of Sleep Medicine

Narcolepsy and Hypersomnia



Scan to play (Video 12) REM sleep behavioural disorder


Apnoea–Hypopnoea Syndrome

Circadian Rhythm Sleep Disorders

Sleep-Related Movement Disorders

Periodic Limb Movement in Sleep and Periodic Limb Movement Disorder

Neurodegenerative Disorders

Neuromuscular Disease

Epilepsy and Sleep

Sleep and Comorbid Neurological Disorders

Headache and Sleep




No. of pages:
© Elsevier India 2018
5th October 2018
Elsevier India
Hardcover ISBN:
eBook ISBN:

About the Authors

U.K. Misra

J Kalita