Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society最新文献

{"title":"Cardiac Rhythm Aberrations in Subacute Sclerosing Panencephalitis: Insights From Heart Rate Variability Analysis.","authors":"L. Viswanathan, Bittanakurike C Nagaraj, R. Mundlamuri, Kandavel Thennarasu, R. Kenchaiah, A. Asranna, M. Nagappa, D. Seshagiri, Jitender Saini, Sanjib Sinha","doi":"10.1097/WNP.0000000000001079","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001079","url":null,"abstract":"PURPOSE\u0000Subacute sclerosing panencephalitis (SSPE) is a fatal neurological disorder resulting from persistent measles virus infection within the brain. Although neurological manifestations have been well-documented, the impact of SSPE on cardiac autonomic function, assessed through heart rate variability (HRV), remains understudied.\u0000\u0000\u0000METHODS\u0000In this prospective single-center study conducted from January 2022 to March 2023 in Southern India, 30 consecutive SSPE patients and age- and sex-matched controls underwent electrocardiogram recordings for HRV analysis. Various HRV parameters were assessed, including time-domain metrics (SD of normal-to-normal intervals, root mean square of successive differences between normal heartbeats, percentage of successive normal interbeat intervals greater than 50 msec), SD1 and SD2 for Poincaré plot analysis, and frequency-domain metrics (low frequency %, high frequency %, low frequency:high frequency ratio).\u0000\u0000\u0000RESULTS\u0000In the study, SSPE patients exhibited markedly reduced HRV. Specifically, SD of normal-to-normal intervals (P = 0.003), percentage of successive normal interbeat intervals greater than 50 msec (P = 0.03), and SD2 (P = 0.0016) were significantly lower compared with controls. Frequency-domain analysis did not reveal significant distinctions. Correlation analysis demonstrated a negative relationship between percentage of successive normal interbeat intervals greater than 50 msec and SSPE severity (r = -0.37, P = 0.042). Heart rate variability did not significantly differ between SSPE stages or with clinical variables. The interbeat interval range showed a narrower distribution in SSPE subjects.\u0000\u0000\u0000CONCLUSIONS\u0000Our study highlights the clinical relevance of HRV analysis in SSPE and autonomic dysfunction throughout the disease course underscoring its importance in SSPE. This investigation provides valuable insights into cardiac autonomic dysfunction probably because of affliction of the central autonomic networks caused by the disease process and may be a contributing factor to mortality in SSPE.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"1151 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140748942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring Real-Time Medication Effects From Electroencephalography.","authors":"Aarti Sathyanarayana, Rima El Atrache, M. Jackson, Sarah Cantley, Latania Reece, Claire Ufongene, T. Loddenkemper, K. Mandl, W. Bosl","doi":"10.1097/WNP.0000000000000946","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000946","url":null,"abstract":"PURPOSE\u0000Evaluating the effects of antiseizure medication (ASM) on patients with epilepsy remains a slow and challenging process. Quantifiable noninvasive markers that are measurable in real-time and provide objective and useful information could guide clinical decision-making. We examined whether the effect of ASM on patients with epilepsy can be quantitatively measured in real-time from EEGs.\u0000\u0000\u0000METHODS\u0000This retrospective analysis was conducted on 67 patients in the long-term monitoring unit at Boston Children's Hospital. Two 30-second EEG segments were selected from each patient premedication and postmedication weaning for analysis. Nonlinear measures including entropy and recurrence quantitative analysis values were computed for each segment and compared before and after medication weaning.\u0000\u0000\u0000RESULTS\u0000Our study found that ASM effects on the brain were measurable by nonlinear recurrence quantitative analysis on EEGs. Highly significant differences (P < 1e-11) were found in several nonlinear measures within the seizure zone in response to antiseizure medication. Moreover, the size of the medication effect correlated with a patient's seizure frequency, seizure localization, number of medications, and reported seizure frequency reduction on medication.\u0000\u0000\u0000CONCLUSIONS\u0000Our findings show the promise of digital biomarkers to measure medication effects and epileptogenicity.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"167 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134439667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beneficial Effect of Repetitive Transcranial Magnetic Stimulation Combined With Physiotherapy After Cervical Spondylotic Myelopathy Surgery.","authors":"M. Farrokhi, Sina Salehi, Negar Nejabat, M. Safdari, Hosein Ramezani Abadeh","doi":"10.1097/WNP.0000000000000949","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000949","url":null,"abstract":"PURPOSE\u0000Cervical spondylotic myelopathy (CSM) is one of the most notable causes of spinal cord impairment among elderly people worldwide. Little is written about the influence of postoperative rehabilitation on recovery of function in patients with CSM. In this study, we assessed the combined effects of repetitive transcranial magnetic stimulation (rTMS) combined with physiotherapy and physiotherapy alone on motor and sensory improvement assessed after spinal cord decompression in patients with CSM.\u0000\u0000\u0000METHODS\u0000This prospective study comprised 52 patients with CSM; they were divided into two randomized groups after spinal cord decompression. The first group (group Ι) includes 26 patients, received a combination of rTMS and physiotherapy. The second group (group ΙΙ) of 26 patients underwent only physiotherapy. The neurologic assessment measures, including American Spinal Cord Injury Association score, modified Japanese Orthopaedic Association score, Ashworth scale, and Nurick grade, were recorded before and after rehabilitation interventions for each patient.\u0000\u0000\u0000RESULTS\u0000According to the neurologic assessment measures, physiotherapy with/without rTMS after surgical decompression corresponded to significant improvement of motor function (P < 0. 01) without significant restoration of sensory function (P > 0. 01). Recovery rates of motor function were significantly better in group Ι than in group ΙΙ (P < 0. 01). There was no significant difference between two groups with respect to age (P = 0.162) and sex (P = 1.00).\u0000\u0000\u0000CONCLUSIONS\u0000Although physiotherapy with/without rTMS improves motor function recovery after CSM surgery, rTMS in combination with physiotherapy leads to a more rapid motor function recovery than physiotherapy alone.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131562204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Intraoperative Motor Evoked Potential Changes and Surgical Interventions in 513 Pediatric Spine Surgeries.","authors":"M. Segura, M. Talarico, Miguel Ángel Miranda, M. Noel","doi":"10.1097/WNP.0000000000000944","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000944","url":null,"abstract":"PURPOSE\u0000(1) To determine probabilities of immediate postoperative new motor deficits after no, reversible, and irreversible motor evoked potentials (MEP) deteriorations and (2) to calculate the same outcome considering whether MEP deteriorations were followed by surgical interventions in the absence of confounding factors.\u0000\u0000\u0000METHODS\u0000We analyzed MEPs from 513 surgeries. Four-limb MEPs were evoked by transcranial electrical stimulation. Baseline recordings were obtained before skin incision and updated before instrumentation. Motor evoked potentials deteriorations were considered significant whenever they showed a persistent, reversible, or irreversible amplitude decrease of >80% of the baseline values.\u0000\u0000\u0000RESULTS\u0000Nine patients showed postoperative new motor deficits. Probabilities of postoperative new motor deficits were null, 2.8%, and 36.8% with no, reversible, and irreversible MEP deteriorations, respectively. The risk of immediate postoperative new motor deficits was significantly lower (P = 0.0002) in reversible MEP compared with irreversible MEP deteriorations. In patients showing reversible/irreversible MEP deteriorations in the absence of confounding factors, surgical interventions compared with nonsurgical interventions significantly decreased the risk of immediate postoperative new motor deficits (P = 0.0216).\u0000\u0000\u0000CONCLUSIONS\u0000This study shows that probabilities of immediate postoperative new motor deficits increase with the severity of intraoperative MEP changes. In addition, our results support the value of surgical interventions triggered by MEP deteriorations to reduce postoperative adverse motor outcomes.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130525461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EEG and MRI Abnormalities in Patients With Psychogenic Nonepileptic Seizures.","authors":"Pouyan Tavakoli Yaraki, Yeyao Joe Yu, Mashael Alkhateeb, Miguel A Arevalo Astrada, S. Lapalme-Remis, S. Mirsattari","doi":"10.1097/WNP.0000000000000941","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000941","url":null,"abstract":"OBJECTIVE\u0000To compare the rate of EEG and MRI abnormalities in psychogenic nonepileptic seizures (PNES) patients with and without suspected epilepsy. Patients were also compared in terms of their demographic and clinical profiles.\u0000\u0000\u0000METHODS\u0000A retrospective analysis of 271 newly diagnosed PNES patients admitted to the epilepsy monitoring unit between May 2000 and April 2008, with follow-up clinical data collected until September 2015.\u0000\u0000\u0000RESULTS\u0000One hundred ninety-four patients were determined to have PNES alone, 16 PNES plus possible epilepsy, 14 PNES plus probable epilepsy, and 47 PNES plus confirmed epilepsy. Fifty-seven of the 77 patients (74.0%) with possible, probable, or definite epilepsy exhibited epileptiform activity on EEG, versus only 16 of the 194 patients (8.2%) in whom epilepsy was excluded. Twenty-four of these 194 patients (12.4%) had MRI abnormalities. Three of 38 patients (7.9%) with both EEG and MRI abnormalities were confirmed not to have epilepsy. In PNES patients with EEG or MRI abnormalities compared with those without, patients with abnormalities were more likely to have epilepsy risk factors, such as central nervous system structural abnormalities, and less likely to report minor head trauma. The presence of EEG abnormalities in PNES-only patients did not influence antiseizure medication reduction, whereas those with MRI abnormalities were less likely to have their antiseizure medications reduced.\u0000\u0000\u0000CONCLUSIONS\u0000Psychogenic nonepileptic seizure patients without MRI or EEG abnormalities are less likely to have associated epilepsy, risk factors for epilepsy, and had different demographic profiles. There is a higher-than-expected level of EEG and MRI abnormalities in PNES patients without epilepsy.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133656096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrographic Features of Epilepsy With Eyelid Myoclonia With Photoparoxysmal Responses.","authors":"Ifrah Zawar, Bijina Shreshtha, D. Benech, R. Burgess, Juan Bulacio, E. P. Knight","doi":"10.1097/WNP.0000000000000942","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000942","url":null,"abstract":"PURPOSE\u0000Epilepsy with eyelid myoclonia (EMA) is characterized by eyelid myoclonia, eyelid closure sensitivity, and photosensitivity. EEG may manifest with frontal-predominant (FPEDs) or occipital-predominant epileptiform discharges (OPEDs). Data on clinical and electrographic features of these two subtypes are lacking. The purpose of our research was to look at baseline electroclinical features of EMA subtypes and to study electrographic findings of patients with EMA during intermittent photic stimulation (IPS).\u0000\u0000\u0000METHODS\u0000We retrospectively identified all patients who had photoparoxysmal responses on EEGs performed at Cleveland clinic between January 01, 2012, and December 31, 2019. Patients who met diagnostic criteria for EMA were studied further.\u0000\u0000\u0000RESULTS\u0000Of the 249 patients with photoparoxysmal responses, 70 (28.1%) had EMA (62 [88.6%] female; the mean age of epilepsy onset: 7.0 ± 7.9 years). Patients with EMA had either FPEDs or OPEDs. Eleven patients with EMA (15.7%) had seizures (4 absence, 5 myoclonic and 2 bilateral tonic-clonic) during IPS. Patients with OPEDs were more likely to have drug-resistant epilepsy; occipital focal IEDs and other focal IEDs (other than frontal/occipital) on baseline EEG; and generalized IEDs with occipital predominance, generalized IEDs with no predominance, or focal IEDs during IPS. Predictors of seizure occurrence during photic stimulation included the presence of focal occipital IEDs on baseline EEG, generalized IEDs with frontal predominance during IPS, and photoparoxysmal response outlasting the stimulus.\u0000\u0000\u0000CONCLUSIONS\u0000Our study provides evidence that EMA has two distinct subtypes, which differ in clinical characteristics, baseline EEG, and EEG during photic stimulation. We highlight diagnostic and prognostic implications of these findings. Our study also details EEG characteristics of patients with EMA during IPS.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129821205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Welcome to the Journal of Clinical Neurophysiology.","authors":"S. Schuele","doi":"10.1097/WNP.0000000000000923","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000923","url":null,"abstract":"","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134311285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sentinel Epileptiform Discharges Activating Two Seizure Networks on Intracranial EEG.","authors":"S. Lapalme-Remis, E. Payne, B. Brinkmann, J. Britton","doi":"10.1097/wnp.0000000000000872","DOIUrl":"https://doi.org/10.1097/wnp.0000000000000872","url":null,"abstract":"SUMMARY\u0000Sentinel epileptiform discharges (SEDs) are epileptiform transients preceding the onset of a focal seizure seen on scalp EEG. Despite their potential localizing value, formal study of SED has been limited. The authors report a patient with MRI-negative focal-onset epilepsy whose seizures on scalp and intracranial EEG were always preceded by SED. Although the location and morphology of the SED was invariable, the seizures after the discharge were of two clearly distinct types, each with different semiology and region of spread on intracranial EEG. This suggests that the SED played a role in activating two distinct seizure networks. A right temporal lobectomy with amygdalohippocampectomy was performed. The resection included both the region of the SED as well as the seizure-onset zone of the more common seizure type, achieving seizure freedom at 3 years after surgery. Further research exploring whether the localization of SED is a reliable indicator of the seizure-onset zone could aid surgical planning in patients whose seizures are preceded by SED.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134547988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Book Identification: A Practical Approach to STEREO EEG.","authors":"Angelica Rivera-Cruz, S. Benbadis","doi":"10.1097/wnp.0000000000000871","DOIUrl":"https://doi.org/10.1097/wnp.0000000000000871","url":null,"abstract":"","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"38 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128940518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Stroke Detected Using Novel SSEP Analysis.","authors":"Michael E Kelly,&nbsp;Lissa Peeling,&nbsp;Jonathan Norton","doi":"10.1097/WNP.0000000000000824","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000824","url":null,"abstract":"<p><strong>Summary: </strong>Using a previously described technique that measures the \"velocity\" of the upswing of the median nerve SSEP, we identified an ischemic event during a carotid surgery that did not meet traditional alarm criteria. Mechanical thrombectomy successfully removed a thrombus, and the patient experienced a good recovery. Analysis of the SSEP waveform may allow for the detection of events missed with traditional alarm criteria.</p>","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":" ","pages":"e17-e18"},"PeriodicalIF":2.4,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25348236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}