Practical Guide for Clinical Neurophysiologic Testing

 

Description:

Focusing on the technical aspects of clinical neurophysiologic testing, Practical Guide for Clinical Neurophysiologic Testing: EP, LTM/ccEEG, IOM, PSG, and NCS/EMG 2nd Edition, offers comprehensive guidance on neurophysiologic testing that picks up where the companion Practical Guide for Clinical Neurophysiologic Testing: EEG ends. Dr. Thoru Yamada and Elizabeth Meng provide advanced content on evoked potentials, intraoperative monitoring, long-term EEG monitoring, epilepsy monitoring, sleep studies, and nerve conduction studies. All chapters have been updated to incorporate recent advancements and new studies and articles. 

 

Table of Contents:

 

Online Videos

Section 1: Evoked Potentials

1 Principles of Evoked Potentials

Introduction

Principles of the Averaging Method

Digital Process

Vertical (Voltage) Resolution and Range

Horizontal (Time) Resolution

Amplifier

Filter Setting of Amplifier

Automatic Artifact Rejection

Data Measurement and Offline Analyses

Polarity Convention

Wave Form Nomenclature

Determination of Normality and Abnormality

Technical Problems in Recording EPs

No Appreciable Response

“Noisy” Responses

Large Stimulus Artifacts

Excessive Sample Rejection (With Auto-Rejection Mode)

Appendix

2 Visual Evoked Potentials

Introduction

Anatomy of the Visual System

Technical Parameters

Stimulus Devices

Visual Angle

Check Size

Luminance

Contrast

Stimulus Repetition Rate

Replication

Dealing with “Noisy” Responses

Physiological Factors

Full-Field Versus Half-Field and Monocular Versus Binocular Stimulation

Age

Visual Acuity

Gender

Body Temperature

Pupillary Size

Amplifier and Signal Averager Settings

Recording Electrodes

Normal VEP in Full-Field Monocular Stimulation

Normal Waveforms and Distribution

Normal Variations

Half-Field Stimulation

Method

Normal VEP to Half-Field Stimulation: “Paradoxical Lateralization”

Abnormal VEP

Latency Abnormalities

Amplitude Abnormalities

Topographic Abnormalities

Waveform Abnormalities

VEP and Clinical Correlates

Optic Neuritis

Multiple Sclerosis

Compressive or Axonal Optic Nerve Lesions

Spinocerebellar Degeneration

Charcot–Marie–Tooth Disease

Parkinson’s Disease

Transverse Myelitis

Chiasmal Lesion

Postchiasmal Lesion

Albinism

Huntington’s Chorea

Cortical Blindness

Functional Blindness, Hysteria, or Malingering

Electroretinogram

Steady-State VEP

VEP by Other Stimulation

Flash and Led Goggle VEPs

Other Stimulus Devices for VEP

3 Brainstem Auditory Evoked Potentials and Auditory Evoked Potentials

Anatomy of Auditory Pathway in Brainstem

Brainstem Auditory Evoked Potentials

Technical Parameters

Stimulation

Filter Setting

Analysis Time

Recording Electrodes

Normal BAEP

Wave I

Wave II

Wave III

Wave IV/V Complex

Electrocochleogram

Cochlear Microphonic Potentials

Summating Potential

Action Potential

Factors that Affect BAEP

Physiological Factors

Nonphysiological Features

Technical Modification to Improve Waveform Identification

Evaluation of the BAEP

Absence of One or More Waves

Latency Abnormalities

Clinical Application of BAEP

Multiple Sclerosis

Cerebellopontine Angle Tumors

Coma and Brain Death

Brainstem Tumor

Vascular Lesions

BAEP in Infants and Young Children

Other Diseases that May Show Abnormalities in BAEP

Middle- and Long-Latency Auditory Evoked Potential

Middle-Latency Auditory Evoked Potential

Long-Latency Auditory Evoked Potential

Auditory P300 ERP

Mismatch Negativity

4 Somatosensory Evoked Potentials

Anatomy of the Sensory System

Somatosensory Evoked Potentials

Methodology/Recording Technique

Stimulation

Frequency Filter Setting

Amplification and Summation

Generation Mechanism of Far-Field Potential

Physiological Factors that Affect SSEP

Age

Body Size

Temperature

Sleep

Short-Latency Upper Extremity SSEP

P9 and N9 Potentials

P11 and N11 Potentials

P13/P14 Potentials

N18 Potential

N20, P20, P22 Potentials

Cervical Responses

Recording Montages for Short-Latency SSEP of Upper Extremity Nerves

Medium- and Long-Latency SSEPs from Upper Extremity Stimulation

Lower Extremity SSEP

Spinal Response

Scalp Potential

Paradoxical Lateralization

Recording Montages for Lower Extremity Nerve

Abnormal Criteria

Obligate Potentials

Anatomical Correlates of SSEP Abnormalities

Peripheral Nerve Lesions

Cervical Cord/Spinal Cord Lesions

High Cervical Cord and Brainstem Lesions

Thalamic Lesions

Cortical/Hemispheric Lesions

SSEP in Specific Neurologic Conditions

Surgical Monitoring

Multiple Sclerosis

Friedreich’s Ataxia

Motor Neuron Disease

Spinocerebellar Degeneration

Huntington’s Chorea

Coma and Brain Death

Myoclonic Epilepsy

Appendix Figures 4A-1 through 4A-12

Appendix

Section 2: Intraoperative Neurophysiologic Monitoring

5 The Technologist’s Role in Neurophysiologic Intraoperative Monitoring

Introduction

IONM Technologist Responsibilities and Skills

Preoperative Preparation

Intraoperative Phase

Postoperative Phase

Equipment and Supplies

Somatosensory Evoked Potentials

Alarm Criteria

Transcranial Motor Evoked Potentials

Alarm Criteria

Contraindication

Pedicle Screw Monitoring

Choosing Proper Modalities

Brainstem Auditory Evoked Potentials

Alarm Criteria

Electroencephalography

Electrocorticography and Intracranial Recording

Electrocorticography

Cortical Somatosensory Evoked Potential

Troubleshooting in the Operating Room

The Effect of Anesthesia

Inhalation Anesthetics

Total Intravenous Anesthesia

Muscle Relaxant

Patient Safety

6 Brain Function Monitoring for Carotid Endarterectomy and Aortic Arch Surgery

Introduction

Anesthesia

EEG Changes during Induction

EEG Patterns at Sub-Mac Concentration

EEG Patterns during Recovery from Anesthesia

Other Factors That Affect EEG

EEG Monitoring

Recording Technique

Preclamp Focal EEG Abnormalities in Relationship to Anesthesia

EEG Changes after Cross-Clamping the Carotid Artery

Predictability of EEG Change

Regional Anesthesia for Awake CEA and EEG Correlates

The Incidence of Stroke after CEA

The Use of SSEP (Somatosensory Evoked Potential) for CEA

The Use of tcMEP (Transcranial Motor Evoked Potential)

Other Monitoring Methods

Aortic Arch Surgery

7 Spinal Cord Monitoring

Introduction

Monitoring Modalities

Somatosensory Evoked Potentials

Upper Extremity SSEP Monitoring

Lower Extremity SSEP Monitoring

Transcranial Motor Evoked Potentials

Other Spinal Cord Monitoring Methods

Recording MEPs From the Epidural or Subdural Space After Transcranial Electric Stimulations

Spinal Cord Stimulation With Recording From Spinal Cord, Scalp, Muscle, or Peripheral Nerve

Peripheral Nerve Stimulation With Spinal Cord Recording

Anesthesia During MEP and SSEP Monitoring

EMG Monitoring for Pedicle Screw Fixation

Intraoperative Monitoring During Selective Dorsal Rhizotomy (SDR)

Pediatric Tethered Cord Repair

Summary and Conclusion

8 Intraoperative Monitoring of the Brainstem and Cranial Nerve Function

Anatomy

Indications for Intraoperative Monitoring of Brainstem Function

Modalities

Brainstem Auditory Evoked Potentials

Somatosensory Evoked Potentials

Motor Evoked Potentials

Visual Evoked Potentials

EMG and Monitoring and Mapping of Cranial Nerve and Nuclei

Anesthesia

Application and Interpretation

Conclusion

Section 3: Long-Term EEG Monitoring

9 Diagnostic Video-EEG Monitoring for Epilepsy and Spells: Indications, Application, and Interpretation

Introduction

Appropriate Selection of Patients for Monitoring

Indications for Video-EEG Monitoring

Seizure/Spell Classification

Seizure Localization

Seizure Frequency

Therapeutic Assessment and Tailoring

Application

Outpatient Monitoring

Inpatient Epilepsy Monitoring

Recording Equipment and Technical Aspects

Digital Reformatting

Seizure and Spike Detection Software

Care of the Monitored Patient

Counseling the Patient Prior to Admission

Admission Orders

Seizure Precautions

Seizure First Aid and Nursing Care

Peri-ictal Patient Assessment

Seizure Provocation

Emergencies in Epilepsy Monitoring Unit Practice

Interpretation

Interictal Recording

Ictal Recording

Spell Classification: Nonepileptic Spells

Nonepileptic Behavioral Events

Physiologic

Seizure Classification

Generalized Seizures

Focal Seizures

Focal to Bilateral Tonic–Clonic

Seizures in Infant and Pediatric Video-EEG Monitoring

Synthesizing the Epilepsy Syndrome: Integrating Video-EEG Data into the Clinical Picture and Other Appropriate Investigations

Pitfalls in Video-EEG Monitoring

Conclusions

Acknowledgements

10 Invasive Video EEG Monitoring in Epilepsy Surgery Candidates: Indications, Technique, and Interpretation

Introduction

Definitions

Indications for Invasive Video-EEG

The Noninvasive Evaluation

The Role of the Epilepsy Surgery Case Conference

The Epilepsy Monitoring Unit: Considerations for Performing Invasive Video-EEG

Personnel

Space Considerations

Safety

The Technique of Invasive Video-EEG

Recording

Stereo-electroencephalography

Data Storage

Review

Outcome Measurements

Concluding Remarks

11 Long-Term Bedside EEG Monitoring for Acutely Ill Patients (LTM/ccEEG)

Introduction

Indication ccEEG

Incidence of NCS or NCSE in the ICU

Recording Technology of ccEEG

Evaluation of ccEEG for NCS or NCSE

The Assessment of Progress for Acute Cerebral Dysfunction

Seizure and Spike Detection Using Computer Software

The use of Quantitative EEG (qEEG) Analyses for ccEEG

Monitoring in the Neonatal ICU

Standardized Critical Care EEG Terminology

EEG Background Descriptions

Rhythmic and Periodic Patterns (RPPs)

Sporadic Epileptiform Discharges

Brief Potentially Ictal Rhythmic Discharges

Ictal–Interictal Continuum

Section 4: Sleep Studies

12 Technology of Polysomnography

Introduction

The Technologists’ Role in the Sleep Lab

Preparing for the Patient

Review of the Physician’s Order

Review of the Medical Record

Preparing for Hookup

Selecting a Montage

Calibration

After Patient Arrives

Orientation

Questionnaires

Interview

Consent Forms

Electrode and Sensor Application

Placement and Application

Additional Recording Parameters

The Recording

Physiologic Calibrations

Observation and Documentation

Ending the Study

Sleep Stage Scoring in the Normal Adult Population

Sleep Cycles

Scoring

Scoring of Periodic Limb Movements in Sleep

Respiratory Event Scoring

Apneas

Hypopneas

Respiratory Effort-Related Arousal

Hypoventilation

Cheyne–Stokes Breathing

Report

Summary

13 Sleep Physiology and Pathology

Introduction

Basic CNS Anatomy and Physiology of Sleep

History

Wakefulness Mechanisms

Sleep Onset Mechanisms

Sleep Pathology

REM Sleep Mechanisms Appreciated Through Narcolepsy with Cataplexy

Obstructive Sleep Apnea and Stroke

Summary

Acknowledgments

14 Sleep Apnea and Related Conditions

Introduction

Obstructive Sleep Apnea

Epidemiology

Pathophysiology

Risk Factors for OSA and Associated Conditions

Other Medical Conditions Associated with Increased OSA Prevalence

Clinical Manifestations of OSA

Physical Examination

OSA Screening

Diagnostic Evaluation of OSA

Management and Treatments

Positive Airway Pressure

Oral Appliance

Hypoglossal Nerve Stimulator

Surgical Approaches

Positional Therapy

Weight Loss

Exercise

Others

Central Apnea

Epidemiology

Pathophysiology

Risk Factors and Associated Conditions

Clinical Manifestations

Physical Examination

Diagnostic Evaluation

Management and Treatment

Treatment of Hyperventilation-Related CSA

CPAP

Supplemental Oxygen during Sleep

Phrenic Nerve Stimulation

Treatment of Hypoventilation-Related CSA

Sleep-Related Hypoventilation

Obesity Hypoventilation Syndrome

Congenital Central Alveolar Hypoventilation

Late-Onset Central Hypoventilation with Hypothalamic Dysfunction or Rapid-Onset Obesity with Hypothalamic Dysfunction, Hypoventilation, and Autonomic Dysregulation (ROHHAD)

Sleep-Related Hypoventilation due to a Medication or Substance

Sleep-Related Hypoventilation Due to a Medical Disorder

Idiopathic Central Alveolar Hypoventilation

Sleep-Related Hypoxemia

15 Evaluating Narcolepsy and Related Conditions

Introduction

Clinical Aspects

Narcolepsy

Other Hypersomnias of Central Origin

Multiple Sleep Latency Test

Pretest Preparation

Performing the MSLT

Concluding the Test

Scoring and Interpreting the MSLT

Interpretation Pitfalls

Maintenance of Wakefulness Test

Procedure

Interpretation

Final Thoughts

16 Parasomnias

Introduction

Polysomnography

Specific Parasomnias

Types of Parasomnias

The Differential Diagnosis

Sleep-Related Movement Disorders

Sleep-Related Epilepsy

Summary

17 Electrophysiological Measurement and Rules for Sleep-Related Movement Disorders

Introduction

Normal Physiologic Movements of Sleep

Phasic Twitches during REM Sleep

Major Body Movements

Isolated Sleep-Related Movements and Normal Variants

Excessive Fragmentary Myoclonus

Alternating Leg Muscle Activation

Hypnagogic Foot Tremor

Sleep Starts (Hypnic Jerks)

Sleep-Related Movement Disorders

Periodic Limb Movements in Sleep

Sleep-related Leg cramps

Sleep-related Bruxism

Sleep-related Rhythmic Movement Disorder

Benign Sleep Myoclonus of Infancy

Propriospinal Myoclonus at Sleep Onset

Restless Legs Syndrome

Dopamine Agonists

α∂ Ligands

Opioids

Benzodiazepines

Section 5: Nerve Conduction Studies

18 Nerve Conduction and Electromyography Studies

Introduction and Recording Technology

NCS Techniques

Motor Study

Sensory Study

F Waves

H Reflex

The Facial Nerve (VII)

The Blink Reflex (Trigeminal V, Facial VII)

Waveform Analysis

Uncommon NCS Techniques

Artifacts

Electrical

Physiological

Understanding Electromyography for the Technologist

Introduction to Electromyography

Waveform Patterns of the Resting Phase

Denervation Potentials

Myotonic Discharges

Complex Repetitive Discharges

Fasciculation Potentials and Myokymic Discharges

Waveform Patterns of the Activation Phase

Motor Unit Potentials

Firing Pattern

Waveform Analysis

Contraindications to EMG

Summary

Index

 

An aparitie	08 Nov 2022
Autor	Thoru Yamada, Elizabeth Meng
Dimensiuni	213 x 276 mm
Editura	LWW
Format	Paperback
ISBN	9781975193577
Limba	Engleza
Nr pag	400
Versiune digitala	DA