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

{"title":"American Clinical MEG Society (ACMEGS) Position Statement #2: The Value of Magnetoencephalography (MEG)/Magnetic Source Imaging (MSI) in Noninvasive Presurgical Mapping of Eloquent Cortices of Patients Preparing for Surgical Interventions.","authors":"A. Bagić, S. Bowyer, H. Kirsch, M. Funke, R. Burgess","doi":"10.1097/WNP.0000000000000366","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000366","url":null,"abstract":"University of Pittsburgh Comprehensive Epilepsy Center (UPCEC), University of Pittsburgh Medical School, Pittsburgh, Pennsylvania, U.S.A.; Neuromagnetism Laboratory, Department of Neurology, Henry Ford Hospital, Detroit, Michigan, U.S.A.; Biomagnetic Imaging Laboratory, UCSF Epilepsy Center, San Francisco, California, U.S.A.; MEG Center, Department of Pediatrics, McGovern Medical School, The University of Texas Health Sciences Center at Houston, Houston, Texas, U.S.A.; and kMagnetoencephalography Laboratory, Cleveland Clinic Epilepsy Center, Cleveland, Ohio, U.S.A.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132893883","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":"Pygopagus Conjoined Twins: A Neurophysiologic Intraoperative Monitoring Schema.","authors":"B. Cromeens, Jennifer L. McKinney, J. Leonard, L. Governale, Judy L. Brown, Christina M Henry, M. Levitt, R. Wood, G. Besner, Monica P. Islam","doi":"10.1097/WNP.0000000000000343","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000343","url":null,"abstract":"Conjoined twins occur in up to 1 in 50,000 live births with approximately 18% joined in a pygopagus configuration at the buttocks. Twins with this configuration display symptoms and carry surgical risks during separation related to the extent of their connection which can include anorectal, genitourinary, vertebral, and neural structures. Neurophysiologic intraoperative monitoring for these cases has been discussed in the literature with variable utility. The authors present a case of pygopagus twins with fused spinal cords and imperforate anus where the use of neurophysiologic intraoperative monitoring significantly impacted surgical decision-making in division of these critical structures.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132701819","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":"Texting Rhythm With Temporal Predominance.","authors":"Stuart R. Tomko, T. Loddenkemper, P. Pearl","doi":"10.1097/WNP.0000000000000353","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000353","url":null,"abstract":"To the Editor: We read with interest the study describing the texting rhythm, characterized as a paroxysmal, time-locked, rhythmic 5 to 6 Hz monomorphic theta rhythm with a generalized, frontocentral-dominant distribution.1 This is definitely important for neurophysiologists to recognize, especially during diagnostic EEG without video in patients being monitored for events to correlate what is an increasingly common activity in the younger generation of “technical natives.” We observed a variation of this phenomenon in a 15-year-old girl who underwent inpatient video-EEG monitoring for behavioral outbursts that ultimately turned out to be nonepileptic events. In this variant, we noted a similar monomorphic theta rhythm with bitemporal predominance that started abruptly with texting and ended with the patient looking up from her iPhone (Fig. 1). Generalized or frontal midline theta rhythms evoked by cognitive processing are well characterized as discussed by the authors. Entrainment of temporal activity has been demonstrated with acoustic signals.2 Our observations corroborate the phenomenon described by the authors and demonstrate a texting rhythm variant of bitemporal predominance, consistent with a spectrum of EEG patterns related to interaction with devices. Specifically, texting rhythm may also present with temporal EEG features, in addition to the generalized, frontocentral-dominant features so well brought to our attention.1","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128762631","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":"TIRDA Originating From Lateral Temporal Cortex in a Patient With mTLE Is Not Related to Hippocampal Activity.","authors":"A. Serafini, N. Issa, S. Rose, Shasha Wu, P. Warnke, James X Tao","doi":"10.1097/WNP.0000000000000306","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000306","url":null,"abstract":"Electrophysiological studies have suggested that temporal intermittent rhythmic delta activity (TIRDA) has a localizing value similar to interictal spikes in patients with temporal lobe epilepsy and is associated with a favorable outcome after temporal lobectomy. However, it remains controversial whether TIRDA is an EEG marker for mesial or lateral temporal epileptogenesis. We simultaneously recorded scalp EEG and stereoencephalography in a patient with mesial temporal lobe epilepsy during epilepsy presurgical evaluation. Seizure onset was localized to the hippocampus. However, TIRDA originated from the lateral temporal cortex, and rhythmic delta activity was not observed concomitantly in the hippocampus. In addition, TIRDA was not associated with repetitive interictal spikes or subclinical seizures in the hippocampus as previously speculated. This case suggests that TIRDA can be an EEG marker that is independent of hippocampal activity and can represent temporal neocortical epileptogenesis.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121210212","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":"Detecting Neonatal Seizures With Computer Algorithms.","authors":"A. Temko, G. Lightbody","doi":"10.1097/WNP.0000000000000295","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000295","url":null,"abstract":"It is now generally accepted that EEG is the only reliable way to accurately detect newborn seizures and, as such, prolonged EEG monitoring is increasingly being adopted in neonatal intensive care units. Long EEG recordings may last from several hours to a few days. With neurophysiologists not always available to review the EEG during unsociable hours, there is a pressing need to develop a reliable and robust automatic seizure detection method-a computer algorithm that can take the EEG signal, process it, and output information that supports clinical decision making. In this study, we review existing algorithms based on how the relevant seizure information is exploited. We start with commonly used methods to extract signatures from seizure signals that range from those that mimic the clinical neurophysiologist to those that exploit mathematical models of neonatal EEG generation. Commonly used classification methods are reviewed that are based on a set of rules and thresholds that are either heuristically tuned or automatically derived from the data. These are followed by techniques to use information about spatiotemporal seizure context. The usual errors in system design and validation are discussed. Current clinical decision support tools that have met regulatory requirements and are available to detect neonatal seizures are reviewed with progress and the outstanding challenges are outlined. This review discusses the current state of the art regarding automatic detection of neonatal seizures.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"150 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122464439","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":"Neuromuscular Ultrasound in the Assessment of Polyneuropathies and Motor Neuron Disease.","authors":"Jack Shen, M. Cartwright","doi":"10.1097/WNP.0000000000000241","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000241","url":null,"abstract":"Neuromuscular ultrasound is an emerging technology for the evaluation of conditions affecting nerve and muscle, with most of the research focusing on focal neuropathies. Despite this focus, researchers have also investigated the ultrasonographic changes that occur in the nerves and muscles of those with more diffuse polyneuropathies and motor neuron diseases, and this review will detail the findings in these conditions. Specific findings are discussed in this article, but general themes will also be presented and include the following: hereditary polyneuropathies show diffuse nerve enlargement, whereas immune-mediated polyneuropathies show more patchy involvement; nerve enlargement is more profound in demyelinating than axonal polyneuropathies; and muscle changes in motor neuron diseases include heterogeneous increases in echogenicity, atrophy, readily detectable fasciculations, and increased subcutaneous tissue thickness.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":" 16","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120831075","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":"ACNS Guideline: Transcranial Electrical Stimulation Motor Evoked Potential Monitoring.","authors":"A. Legatt, R. Emerson, C. Epstein, D. Macdonald, V. Deletis, R. Bravo, Jaime R. López","doi":"10.1097/WNP.0000000000000253","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000253","url":null,"abstract":"Motor evoked potentials (MEPs) are electrical signals recorded from neural tissue or muscle after activation of central motor pathways. They complement other clinical neurophysiology techniques, such as somatosensory evoked potentials (SEPs), in the assessment of the nervous system, especially during intraoperative neurophysiologic monitoring (IONM). Somatosensory evoked potentials directly assess only a part of the spinal cord, the dorsal columns (Emerson, 1988), and also the medial lemniscus, the thalamocortical radiations, and somatosensory cortex. Because they provide indirect surveillance of the motor tracts, their use has been shown to improve neurologic outcomes during spinal surgery (Nuwer et al., 1995). However, SEPs can fail to detect damage to the spinal cord motor pathways when the dorsal columns are spared (Ben-David et al., 1987; Ginsburg et al., 1985; Jones et al., 2003; Krieger et al., 1992; Legatt et al., 2014; Zornow et al., 1990); this led to the development of techniques for directly monitoring the central motor pathways. Most often, this is accomplished using transcranial electrical stimulation (TES) of the brain and recording of evoked neural or myogenic activity caudal to the area that is at risk during surgery (Legatt, 2002). During TES, high-intensity stimuli must be delivered to the scalp to stimulate the brain through the intact skull, with stimulus voltage and current levels far above those used to elicit SEPs. If a craniotomy permits direct stimulation of motor cortex by electrodes placed on the brain surface, low-intensity direct cortical stimulation can also be used to elicit MEPs for IONM (Szelényi et al., 2007b; Taniguchi et al., 1993). Direct cortical stimulation is outside the scope of this guideline, but the recommendations herein for the recording of the MEPs that are elicited by transcranial electrical brain stimulation would also apply to recording of MEPs elicited by direct cortical stimulation. Transcranial magnetic stimulation has also been used to elicit MEPs by inducing electrical current flows within the brain tissue without passing large amounts of current through the scalp. This reduces stimulation of pain fibers in the scalp, skull, and meninges and makes it a practical technique for MEP studies in awake subjects (Chen et al., 2008). However, transcranial magnetic stimulation is not the optimal MEP technique for IONM because of the anesthetic suppression of transcranial magnetic stimulation– MEPs which are generated mainly by eliciting I-waves (see section on Definitions and Physiology, below) and difficulties in maintaining a constant position of the coil relative to the patient’s head (Legatt, 2004). Neither TES with single stimulus pulses nor transcranial magnetic stimulation consistently produces robust myogenic MEPs suitable for IONM. The commercial availability of stimulators that can deliver trains of high-intensity electrical pulses has made reliable MEP monitoring using TES possible in most","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"33 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130490656","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":"Status Epilepticus: Do Treatment Guidelines Make Sense?","authors":"I. Unterberger","doi":"10.1097/WNP.0000000000000222","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000222","url":null,"abstract":"Status epilepticus represents an acute, potentially life-threatening emergency with considerable risks of morbidity and mortality, mainly depending on age at onset, underlying etiology, seizure severity, and medical comorbidities. Recent European and North American guidelines on management and treatment of status epilepticus strongly recommend prompt treatment to prevent further complications. At present, following a staged treatment protocol is recommended. Benzodiazepines are the treatment of choice in early status epilepticus, but there are no class I data supporting treatment recommendations on the choice of antiepileptic drugs for established and refractory status epilepticus. This article reviews advantages and potential drawbacks of the available guidelines.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124228476","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":"How to Manage Electrical Status Epilepticus in Sleep.","authors":"P. Veggiotti, M. Pera, S. Olivotto, V. De Giorgis","doi":"10.1097/WNP.0000000000000235","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000235","url":null,"abstract":"Electrical status epilepticus in sleep is an age-dependent syndrome with the characteristic pattern of continuous spike and waves during non-rapid eye movement sleep. Most children can present developmental deterioration. The demonstration of the EEG pattern has to rely on all night long EEG recordings. A comprehensive neuropsychologic evaluation with periodic reassessment should be performed. For the idiopathic forms of electrical status epilepticus in sleep, clobazam could be considered as the first-line therapy; in the other cases, corticosteroids, in particular intravenous methylprednisolone pulse therapy, remain the most effective and should be considered the therapy of choice.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124932257","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":"Vasculopathy, Ischemia, and the Lateral Lumbar Interbody Fusion Surgery: Report of Three Cases.","authors":"David W. Allison, R. Allen, David Kohanchi, C. B. Skousen, Yu-po Lee, Jeffrey H. Gertsch","doi":"10.1097/WNP.0000000000000136","DOIUrl":"https://doi.org/10.1097/WNP.0000000000000136","url":null,"abstract":"Multi-modal neurophysiologic monitoring consisting of triggered and spontaneous electromyography and transcranial motor-evoked potentials may detect and prevent both acute and slow developing mechanical and vascular nerve injuries in lateral lumbar interbody fusion (LLIF) surgery. In case report 1, a marked reduction in the transcranial motor-evoked potentials on the operative side alerted to a 28% decrease in mean arterial blood pressure in a 54-year-old woman during an L3-4, L4-5 LLIF. After hemodynamic stability was regained, transcranial motor-evoked potentials returned to baseline and the patient suffered no postoperative complications. In case report 2, a peroneal nerve train-of-four stimulation threshold of 95 mA portended the potential for a triggered electromyography false negative in a 70-year-old woman with type 2 diabetes, peripheral neuropathy, and body mass index of 30.7 kg/m undergoing an L3-4, L4-5 LLIF. Higher triggered electromyography threshold values were applied to this patient's relatively quiescent triggered electromyography and the patient suffered no postoperative complications. In case report 3, the loss of right quadriceps motor-evoked potentials detected a retractor related nerve injury in a 59-year-old man undergoing an L4-5 LLIF. The surgery was aborted, but the patient suffered persistent postoperative right leg paresthesia and weakness. These reports highlight the sensitivity of peripheral nerve elements to ischemia (particularly in the presence of vascular risk factors) during the LLIF procedure and the need for dynamic multi-modal intraoperative monitoring.","PeriodicalId":117726,"journal":{"name":"Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130579282","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}