Clinical Neurophysiology

Fourth Edition

MD Devon I. Rubin and MD Jasper R. Daube

Contemporary Neurology Series

Reviews basic concepts underlying each technique, role, interpretation, and application of each neurophysiological study
Details evaluation of disease in the central or peripheral nervous system
Covers the basic concepts underlying each of the testing techniques and provides comprehensive descriptions of the methods and wide range of electrophysiologic testing

Clinical Neurophysiology

Fourth Edition

MD Devon I. Rubin and MD Jasper R. Daube

Description

Clinical neurophysiologic testing is an important component of evaluating patients with complaints that may be attributed to diseases of the central or peripheral nervous system. This classic volume in the Contemporary Neurology Series covers the basic concepts underlying each of the testing techniques and provides comprehensive descriptions of the methods and wide range of electrophysiologic testing available for patients with epilepsy, neuromuscular diseases, movement disorders, demyelinating diseases, sleep disorders, autonomic disorders and those undergoing orthopedic and neurosurgical procedures. This text details the role of each study, the interpretation of findings, and their application clinical problems.

This text describes the multiple diagnostic procedures for diverse diseases of the neuromuscular system, including: electroencephalography (EEG); electromyography and nerve conduction studies; single fiber EMG; polysomnography; surface EMG patterns, blood pressure, pulse, sweat measures; vestibular function testing; deep brain stimulator physiology; and intraoperative monitoring. It is a practical textbook for neurologists, physiatrists and clinical neurophysiologists in clinical or research practice or in training.

Key Features of the New Edition Include:
1. Fully updated chapters to reflect new research and techniques in clinical neurophysiology.
2. Updated images illustrating key elements of techniques and basic concepts.
3. Case examples for practical application.

Clinical Neurophysiology

Fourth Edition

MD Devon I. Rubin and MD Jasper R. Daube

Contemporary Neurology Series

Part 1 Basic Neurophysiology
Chapter 1 Basics of Neurophysiology Squire M. Stead, MD, PhD
Chapter 2 Electrophysiologic Generators in Clinical Neurophysiology Terrence D. Lagerlund, MD
Chapter 3 Waveforms and Artifacts Devon I. Rubin, MD
Jasper R. Daube, MD
Part 2 CLINICAL ELECTROENCEPHALOGRAPHY
Adult EEG
Chapter 4 Adult EEG – Normal and Benign Variants Jeffrey W. Britton, MD
Chapter 5 Adult EEG – Artifacts and the EEG Jeffrey W. Britton, MD
Chapter 6 Adult EEG – Epileptiform Activity Katherine H. Noe, MD, PhD
Joseph F. Drazkowski, MD
Chapter 7 Adult EEG – Abnormal Non-epileptiform Activity Joseph I. Sirven, MD
Barbara Westmoreland, MD
Pediatric EEG
Chapter 8 Pediatric EEG – Normal Maturational Changes Katherine C. Nickels, MD
Chapter 9 Pediatric EEG – Epileptiform Activity Elaine C. Wirrell, MD
Lily Wong-Kisiel, MD
EEG – Special Studies and Surgical Monitoring
Chapter 10 Computer-Assisted Ambulatory Electroencephalography Jerry J. Shih, MD
William O. Tatum, DO
Chapter 11 Prolonged Video Electroencephalography Cheolsu Shin, MD
Chapter 12 Electroencephalographic Special Studies Gregory A. Worrell, MD, PhD
Terrence D. Lagerlund, MD
Chapter 13 Epilepsy Surgery Evaluation: EEG and SPECT Joseph F. Drazkowski, MD
Chapter 14 EEG Trend Analysis in the ICU Amy Z. Crepeau, MD
Chapter 15 Digital Signal Processing Terrence D. Lagerlund, MD
Chapter 16 Clinical Applications: Assessing Central Nervous system Symptoms Elson L. So, MD
Part 3 CLINICAL ELECTROMYOGRAPHY
Nerve Conduction Studies
Chapter 17 Motor Nerve Conduction Studies: Compound Muscle Action Potentials Lyell K. Jones, MD
James C. Watson, MD
Chapter 18 Sensory Nerve Conduction Studies: Sensory Nerve Action Potentials Eric J. Sorenson, MD
Chapter 19 Late Responses: F waves and H reflexes Ruple S. Laughlin, MD
Chapter 20 Repetitive Nerve Stimulation Studies Kathleen D. Kennelly, MD, PhD
Chapter 21 Cranial Reflexes and Related Testing Benn E. Smith, MD
Chapter 22 Quantitative Motor Unit Number Estimates Eric J. Sorenson, MD
Jasper R. Daube, MD
Chapter 23 Technical Issues and Potential Complications of Nerve Conduction Studies Devon I. Rubin, MD
Needle Electromyography
Chapter 24 Needle Electromyography Devon I. Rubin, MD
Chapter 25 Quantitative Electromyography Benn E. Smith, MD
Chapter 26 Single Fiber Electromyography Brian A. Crum, MD
C. Michel Harper, Jr. MD
Chapter 27 Neuromuscular Ultrasound in the EMG Lab Andrea J. Boon, MD
Chapter 28 Pitfalls and Potential Complications of Needle EMG Devon I. Rubin, MD
Chapter 29 Application of Clinical Neurophysiology: Assessing Peripheral Neuromuscular Conditions Devon I. Rubin, MD
Jasper R. Daube, MD
Part 4 EVOKED POTENTIALS
Chapter 30 Somatosensory Evoked Potentials James C. Watson, MD
Jonathan L. Carter, MD
Chapter 31 Visual Evoked Potentials Jonathan L. Carter, MD
Chapter 32 Brainstem Auditory Evoked Potentials in Central Disorders Jonathan L. Carter, MD
Chapter 33 Motor Evoked Potentials Jeffrey A. Strommen, MD
Andrea J. Boon, MD
Chapter 34 Contact Heat Evoked Potentials Benn E. Smith, MD
Part 5 ASSESSMENT OF AUTONOMIC FUNCTION
Chapter 35 Autonomic Physiology William P. Cheshire, Jr., MD
Chapter 36 Quantitative Sudomotor Axon Reflex and Related Tests Phillip A. Low, MD
Chapter 37 Evaluation of Adrenergic Function Phillip A. Low, MD
Chapter 38 Thermoregulatory Sweat Test Robert D. Fealey, MD
Chapter 39 Cardiovagal Reflexes William P. Cheshire, Jr., MD
Chapter 40 Electrophysiology of Pain Paola Sandroni, MD, PhD
Part 6 CLINICAL NEUROPHYSIOLOGY OF MOVEMENT DISORDERS
Chapter 41 Movement-Related Potentials and Event-Related Potentials Rene L. Utianski , PhD
John N. Caviness, MD
Chapter 42 Long Latency Reflexes and the Silent Period Jay A. Van Gerpen, MD
John N. Caviness, MD
Chapter 43 Electrophysiology of Movement Disorders Bryan T. Klassen, MD
James H. Bower, MD
Joseph Y. Matsumoto, MD
Jay A. Van Gerpen, MD
John N. Caviness, MD
Chapter 44 Deep Brain Stimulation Electrophysiology Bryan T. Klassen, MD
Part 7 ASSESSMENT OF SLEEP
Chapter 45 Assessment of Sleep and Sleep Disorders Michael H. Silber, MD, ChB
Cameron D. Harris
Part 8 INTRAOPERATIVE MONITORING
Chapter 46 Cerebral Function Monitoring Elson L.So, MD
Chapter 47 Brain Stem and Cranial Nerve Monitoring Brian A. Crum, MD
Chapter 48 Spinal Cord Monitoring Jeffrey A. Strommen, MD
Andrea J. Boon, MD
Chapter 49 Peripheral Nervous System Monitoring Jeffrey A. Strommen, MD
C. Michel Harper, MD
Part 9 ASSESSMENT OF THE VESTIBULAR AND ACOUSTIC SYSTEM
Chapter 50 Audiogram, Acoustic Reflexes, and Evoked Otoacoustic Emissions Christopher D. Bauch, PhD
Wayne O. Olsen
Chapter 51 Brain Stem Auditory Evoked Potentials in Peripheral Acoustic Disorders Christopher D. Bauch, PhD
Wayne O. Olsen
Chapter 52 Vertigo and Imbalance Davin A. Zapala, PhD
Part 10 ELECTRICAL CONCEPTS AND SAFETY
Chapter 53 Electricity and Electronics in Clinical Neurophysiology Terrence D. Lagerlund, MD
Chapter 54 Volume Conduction Terrence D. Lagerlund, MD Devon I. Rubin, MD
Jasper R. Daube, MD
Chapter 55 Electrical Safety in the Laboratory and Hospital Terrence D. Lagerlund, MD

Clinical Neurophysiology

Fourth Edition

MD Devon I. Rubin and MD Jasper R. Daube

Contemporary Neurology Series

Author Information

MD Devon I. Rubin, Professor of Neurology, Consultant in Neurology, Department of Neurology, Mayo Clinic, and MD Jasper R. Daube, Emeritus Professor of Neurology, Mayo Clinic

Devon Rubin is professor of neurology and consultant in the department of neurology at Mayo Clinic Jacksonville, where he serves as the director of the EMG laboratory. He completed his neurology and clinical neurophysiology training at Mayo Clinic, Rochester, MN. His special interest and area of expertise is in education in clinical neurophysiology, and he has developed and authored numerous, unique interactive digital EMG teaching tools. He has been the recipient of the Mayo Clinic Distinguished Educator Award for recognition of his excellence in education.

Jasper Daube is a clinical neurologist and clinical neurophysiologist with degrees from Princeton University, University of Rochester School of Medicine, University of Wisconsin, and Mayo Clinic. His special interests include neuromuscular diseases. He is an Honorary Member and Distinguished Neurology Teacher of the American Neurological Association; has won the Presidential Award and Neurology Teacher Award; and President American Association of Electrodiagnostic Medicine.

Contributors:

Christopher D. Bauch, PhD
Consultant, Division of Audiology, Mayo Clinic, Rochester, Minnesota; Associate Professor of Audiology, College of Medicine, Mayo Clinic

Andrea J. Boon, MD
Consultant, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota; Associate Professor of Neurology and of Physical Medicine and Rehabilitation, College of Medicine, Mayo Clinic

Jeffrey W. Britton, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota;
Professor of Neurology, College of Medicine, Mayo Clinic

James H. Bower, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Associate Professor of Neurology, College of Medicine, Mayo Clinic

Jonathan L. Carter, MD
Consultant, Department of Neurology, Mayo Clinic, Scottsdale, Arizona; Associate Professor of Neurology, College of Medicine, Mayo Clinic

John N. Caviness, MD
Consultant, Department of Neurology, Mayo Clinic, Scottsdale, Arizona; Professor of Neurology, College of Medicine, Mayo Clinic

William P. Cheshire, Jr., MD
Consultant, Department of Neurology, Mayo Clinic, Jacksonville, Florida; Professor of Neurology, College of Medicine, Mayo Clinic

Amy Z. Crepeau, MD
Senior Associate Consultant, Department of Neurology, Mayo Clinic, Scottsdale, Arizona; Assistant Professor of Neurology, College of Medicine, Mayo Clinic

Brian A. Crum, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Assistant Professor of Neurology, College of Medicine, Mayo Clinic

Jasper R. Daube, MD
Emeritus Professor of Neurology, College of Medicine, Mayo Clinic

Joseph F. Drazkowski, MD
Consultant, Department of Neurology, Mayo Clinic, Scottsdale, Arizona; Professor of Neurology, College of Medicine, Mayo Clinic

Robert D. Fealey, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Assistant Professor of Neurology, College of Medicine, Mayo Clinic

C. Michel Harper, Jr., MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Professor of Neurology, College of Medicine, Mayo Clinic

Cameron D. Harris
Associate, Sleep Disorders Center, Mayo Clinic, Rochester, Minnesota; Assistant Professor of Medicine, College of Medicine, Mayo Clinic

Lyell K. Jones, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Assistant Professor of Neurology, College of Medicine, Mayo Clinic

Kathleen D. Kennelly, MD, PhD
Consultant, Department of Neurology, Mayo Clinic, Jacksonville, Florida; Assistant Professor of Neurology, College of Medicine, Mayo Clinic

Bryan T. Klassen, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Assistant Professor of Neurology, College of Medicine, Mayo Clinic

Terrence D. Lagerlund, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Associate Professor of Neurology, College of Medicine, Mayo Clinic

Ruple S. Laughlin, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Assistant Professor of Neurology, College of Medicine, Mayo Clinic

Phillip A. Low, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Professor of Neurology, College of Medicine, Mayo Clinic

Joseph Y. Matsumoto, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Professor of Neurology, College of Medicine, Mayo Clinic

Katherine C. Nickels, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Assistant Professor of Neurology, College of Medicine, Mayo Clinic

Katherine H. Noe, MD, PhD
Consultant, Department of Neurology, Mayo Clinic, Scottsdale, Arizona; Associate Professor of Neurology, College of Medicine, Mayo Clinic

Wayne O. Olsen, MD
Emeritus Professor of Otolaryngology, College of Medicine, Mayo Clinic

Devon I. Rubin, MD
Consultant, Department of Neurology, Mayo Clinic, Jacksonville, Florida; Professor of Neurology, College of Medicine, Mayo Clinic

Paola Sandroni, MD, PhD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Professor of Neurology, College of Medicine, Mayo Clinic

Jerry J. Shih, MD
Consultant, Department of Neurology, Mayo Clinic, Jacksonville, Florida; Associate Professor of Neurology, College of Medicine, Mayo Clinic

Cheolsu Shin, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Associate Professor of Neurology and Assistant Professor of Pharmacology, College of Medicine, Mayo Clinic

Michael H. Silber, MB ChB
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Professor of Neurology, College of Medicine, Mayo Clinic

Joseph I. Sirven, MD
Consultant, Department of Neurology, Mayo Clinic, Scottsdale, Arizona; Professor of Neurology, College of Medicine, Mayo Clinic

Benn E. Smith, MD
Consultant, Department of Neurology, Mayo Clinic, Scottsdale, Arizona; Associate Professor of Neurology, College of Medicine, Mayo Clinic

Elson L. So, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Professor of Neurology, College of Medicine, Mayo Clinic

Eric J. Sorenson, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Professor of Neurology, College of Medicine, Mayo Clinic

Squire M. Stead, MD, PhD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Assistant Professor of Neurology, College of Medicine, Mayo Clinic

Jeffrey A. Strommen, MD
Consultant, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota; Assistant Professor of Physical Medicine and Rehabilitation, College of Medicine, Mayo Clinic

William O. Tatum, DO
Consultant, Department of Neurology, Mayo Clinic, Jacksonville, Florida; Professor of Neurology, College of Medicine, Mayo Clinic

Rene L. Utianski, PhD
Research Fellow, Department of Neurology, Mayo Clinic, Scottsdale, Arizona; Assistant Professor of Neurology, College of Medicine, Mayo Clinic

Jay A. Van Gerpen, MD
Consultant, Department of Neurology, Mayo Clinic, Jacksonville, Florida; Associate Professor of Neurology, College of Medicine, Mayo Clinic

James C. Watson, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Assistant Professor of Neurology, College of Medicine, Mayo Clinic

Barbara F. Westmoreland, MD
Emeritus Professor of Neurology, College of Medicine, Mayo Clinic

Elaine C. Wirrell, MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Professor of Neurology, College of Medicine, Mayo Clinic

Lily C. Wong-Kisiel MD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Assistant Professor of Neurology, College of Medicine, Mayo Clinic

Gregory A. Worrell, MD, PhD
Consultant, Department of Neurology, Mayo Clinic, Rochester, Minnesota; Professor of Neurology, College of Medicine, Mayo Clinic

David A. Zapala, PhD
Consultant, Section of Audiology, Mayo Clinic, Jacksonville, Florida; Associate Professor of Audiology, College of Medicine, Mayo Clinic