Epilepsy & Behavior 21 (2011) 489

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Book Review

Standard Electroencephalography in Clinical Psychiatry: A PracticalHandbook, Nash Boutros, Silvana Galderisi, Oliver Pogarell, SilvanaRiggio (Eds.), Wiley–Blackwell, Oxford/Chichester, 2011, Paperback.198 pp. £34.99/€42.00/$57.95. ISBN: 978-0-470-74782-7

It is easy to overlook that the field of electroencephalographyemerged directly from the field of psychiatry, as studies have reportedthat electroencephalograms (EEGs) arising from psychiatric referralshave the lowest abnormality detection rates. Electroencephalographyis used in psychiatry to elucidate the etiology and pathologicalmechanisms of psychiatric disorders, thus aiding clinical diagnosisand guiding appropriate treatment. The non-invasiveness and lowcostof the procedure appear to attract clinicians to use of this investigativetool. Psychiatrists should base their use of electroencephalographyon robust clinical assessment and should be aware of the limitationsinherent in the procedure (Badrakalimuthu VR, Swamiraju R, deWaal H. Adv Psychiatr Treat 2011;17:114–21). Thus, it becomesessential that clinicians have a practical handbook to guide themin understanding and interpreting electroencephalographic resultsin the complex context of psychiatric disorders with behavioraldisturbances, comorbid physical illnesses, and substance misuse andvarying compliance with psychotropic medications.

Since the landmarkbook EEGand Evoked Potentials in Psychiatry andBehavioral Neurology by Hughes and Wilson in 1983, there has been ahuge void in bringing together the latest understanding of electroen-cephalography and the development of psychiatry clinics. StandardElectroencephalography in Clinical Psychiatry: A Practical Handbookoffers a solution with its 12 well-written chapters that bring togetherthe theory and technique that underpin electroencephalography alongwith the clinical presentations.

The focus of Chapter 2 is elucidating the electrophysiologicalbasis of electroencephalography, which is very important as manyabnormalities arise from ionic imbalances caused by varied etiologiesincluding metabolic disorders. Chapter 3 describes the technique ofrecording an EEG and is complemented by traces that are impacted onby various artifacts, biological and technical. This may help to avoidthe false-positive diagnoses that electroencephalography can leadclinicians with untrained eyes to make. In my opinion, Chapter 4,with its elaborate description of normal rhythmpatterns accompaniedby EEG traces, is the sheet anchor of this book, particularly forclinicians who may have just started their journey to decipher thecryptic language from the cortex.

doi:10.1016/j.yebeh.2011.05.011

Chapter 5 focuses on abnormal EEG patterns caused by epilepti-formactivity,metabolic disorders that can be associatedwithdelirium,encephalopathies, ischemic disorders, and space-occupying lesions.Contrast this with Chapter 6, which emphasizes the delineationbetween epilepsy and psychogenic nonepileptic attacks, more impor-tantly as the latter are probably more common the former. This ishelpful to a psychiatrist working in a neuropsychiatric or liaison clinic,where an understanding of electroencephalography is very helpful insolving the clinical conundrums that psychogenic nonepileptic attackscan produce.

Chapters 8 to 10 concern electroencephalographic findings inpsychiatric disorders. The chapters include clinical vignettes and EEGtraces that will undoubtedly go a long way in helping clinicians makeappropriate referrals for electroencephalography and understand anabnormal result in the context of a clinical case scenario. Chapter 11,on the abnormal rhythm patterns that psychotropic medicationscan produce, is essential in delineating the impact of psychotropicmedications on ion channels mediated by various receptors. The finalchapter summarizes the current training provisions (or lack of suchprovisions, in many cases) across various countries, which is veryimportant as I expect that readers of this bookwill urge their respectiveacademic bodies and faculties to rectify this travesty in being blind toone of the easily accessible investigations.

Although the preface sets the terms of reference for this book,which excludes qualitative electroencephalography, understandablystill in its infancy, it would have been very effective if the advances inqualitative electroencephalography had been incorporated into theotherwise well-written chapters. Future editions of this book wouldbenefit from addition of section at the end of each chapter that teststhe learning of the reader through questions associated with clinicalscenarios or electroencephalographic traces. In summary, this bookwill most certainly be included in psychiatry curricula and will be amilestone of which Hans Berger will be proud.

V.R. BadrakalimuthuSpecialty Registrar in Old Age Psychiatry,

Cambridgeshire & Peterborough Foundation Trust,Cambridge, UK. Fax: +44 1223218633.

E-mail address: raja.badrakalimuthu@yahoo.co.uk.

7 May 2011