Journal of Clinical Neurophysiology最新文献_第2页

Association Between Seizure Periodicity and Responsiveness to Intravenous Antiseizure Medications in Critically Ill Patients. 危重患者癫痫发作周期与静脉注射抗癫痫药物反应性的关系。

IF 1.8 4区医学

Journal of Clinical Neurophysiology Pub Date : 2026-09-14 DOI: 10.1097/WNP.0000000000001299

Qi Huang, Zhijian Liang, Juan Ma, Xing Wei, Meigang Ma, Lanfeng Sun, Yuting Zhu, Yuan Wu

{"title":"Association Between Seizure Periodicity and Responsiveness to Intravenous Antiseizure Medications in Critically Ill Patients.","authors":"Qi Huang, Zhijian Liang, Juan Ma, Xing Wei, Meigang Ma, Lanfeng Sun, Yuting Zhu, Yuan Wu","doi":"10.1097/WNP.0000000000001299","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001299","url":null,"abstract":"Purpose: Seizures are common in critically ill patients, with a subset exhibiting cyclical organization. This study aimed to determine whether seizure cycle is associated with responsiveness to intravenous antiseizure medications.Methods: We retrospectively reviewed continuous EEG recordings and included those containing repeated seizures. Data were segmented into assessment units (AUs) based on intravenous antiseizure medication bolus timing, which served as the unit of analysis. Circular strength within each AU was quantified using the mean resultant length, with values closer to one indicating stronger alignment. Pharmacologic response was defined as seizure remission within a postbolus assessment window, the duration of which was defined as three times the mean seizure period within the AU. Associations were evaluated using multivariable and population-averaged logistic regression models.Results: We included 88 AUs from 25 critically ill patients (mean AU duration, 1.1 hours; mean number of seizures per AU, seven events). The mean resultant length was 0.71 (range, 0.11-0.99). Strong periodicities were observed across etiologic groups. Seizure remission occurred in 17 of 88 AUs. Higher mean resultant length was associated with lower odds of remission (logistic model: OR = 0.020; 95% CI, 0.001-0.533; p = 0.020; population-averaged model: OR = 0.067; 95% CI, 0.008-0.560; p = 0.013). In some instances, usage of phenobarbital was associated with seizure alleviation even in AUs with strong periodicity.Conclusions: Our preliminary findings suggest that greater seizure cycle was associated with reduced responsiveness to intravenous antiseizure medications.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148968923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

SEEG Implantation for Opercular Epilepsies. 眼性癫痫的SEEG植入治疗。

IF 1.8 4区医学

Journal of Clinical Neurophysiology Pub Date : 2026-09-01 Epub Date: 2026-04-03 DOI: 10.1097/WNP.0000000000001255

Alexis Robin, Philippe Kahane, Dang Khoa Nguyen

{"title":"SEEG Implantation for Opercular Epilepsies.","authors":"Alexis Robin, Philippe Kahane, Dang Khoa Nguyen","doi":"10.1097/WNP.0000000000001255","DOIUrl":"10.1097/WNP.0000000000001255","url":null,"abstract":"Summary: Insulo-opercular epilepsies are rare, and pure opercular epilepsies are even rarer in the field of epilepsy surgery. They represent a complex form of focal epilepsy, often associated with noninformative MRI findings and, in some cases, extensive epileptogenic networks. In this context, stereoelectroencephalography (SEEG) is a critical tool for precise characterization of the epileptogenic zone (EZ) and for guiding surgical treatment; in selected cases, it may also serve as a therapeutic intervention through radiofrequency thermocoagulation (RFTC). The insulo-opercular region exhibits intricate intra- and extraregional structural and functional connectivity, requiring individualized implantation strategies. SEEG implantation combining orthogonal electrodes sampling different opercular areas with oblique electrodes targeting the insula enables comprehensive coverage of the epileptogenic network. Hypothesis-driven, patient-specific SEEG implantation-integrating detailed anatomical, functional, and semiological considerations-is essential for the evaluation and treatment of pure opercular and insulo-opercular epilepsies. Strategically tailored coverage not only enhances diagnostic accuracy but also enables targeted therapeutic interventions, ultimately improving surgical outcomes while minimizing postoperative risks.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"514-523"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148330043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Semiology of Opercular Epilepsies. 眼性癫痫的符号学。

IF 1.8 4区医学

Journal of Clinical Neurophysiology Pub Date : 2026-09-01 DOI: 10.1097/WNP.0000000000001277

Alexandra Montavont, Caroline Giroudon, Zeynep Gokce-Samar, Karine Ostrowsky-Coste

{"title":"Semiology of Opercular Epilepsies.","authors":"Alexandra Montavont, Caroline Giroudon, Zeynep Gokce-Samar, Karine Ostrowsky-Coste","doi":"10.1097/WNP.0000000000001277","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001277","url":null,"abstract":"Summary: In this systematic review, we aimed to characterize the semiology of 'pure' opercular seizures by identifying cases in which the epileptogenic zone was restricted to the operculum. Seventy patients from 24 articles were included and categorized into four anatomic groups: 11 frontal, 27 central, 14 parietal, and 18 temporal operculum cases. Across these four anatomic regions, we identified the following semiological patterns: Frontal opercular seizures were characterized by a lower frequency of auras, most commonly nonpainful somatosensory sensations affecting the limbs or trunk and never exclusively the face, along with frequent elementary motor signs. Central opercular seizures exhibited the highest frequency of auras, predominantly nonpainful somatosensory sensations often involving the face; the central operculum was the only region associated with negative motor seizures. Parietal opercular seizures showed the greatest diversity of auras, notably painful sensations, and were associated with a higher prevalence of hypermotor behavior. Temporal opercular seizures were characterized by auditory hallucinations and a higher incidence of generalized tonic-clonic seizures.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":"43 6","pages":"504-513"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Generalized Periodic Discharges: Nonconvulsive Status Epilepticus or Diffuse Encephalopathy-A Case Comparison. 广泛性周期性放电：非惊厥性癫痫持续状态或弥漫性脑病1例比较。

IF 1.8 4区医学

Journal of Clinical Neurophysiology Pub Date : 2026-09-01 Epub Date: 2026-04-02 DOI: 10.1097/WNP.0000000000001256

Chanawee Hirunpattarasilp, Joshua Edmondson, Daniel Wood, Guadalupe Fernandez-BacaVaca, Neel Fotedar

{"title":"Generalized Periodic Discharges: Nonconvulsive Status Epilepticus or Diffuse Encephalopathy-A Case Comparison.","authors":"Chanawee Hirunpattarasilp, Joshua Edmondson, Daniel Wood, Guadalupe Fernandez-BacaVaca, Neel Fotedar","doi":"10.1097/WNP.0000000000001256","DOIUrl":"10.1097/WNP.0000000000001256","url":null,"abstract":"Summary: Nonconvulsive status epilepticus (NCSE) refers to persistent epileptiform discharges on EEG meeting the Salzburg criteria. Nonconvulsive status epilepticus with coma mostly occurs in critically ill patients without preceding convulsions and without a history of chronic epilepsy, where the EEG typically shows generalized periodic discharges (GPDs). Nonconvulsive status epilepticus without coma is typically described in patients with chronic epilepsy and is associated with a different alteration of consciousness where patients are awake with eyes open, retained posture, however unresponsive with amnesia (known as dialepsis). The GPDs in NCSE with coma could represent an epiphenomenon and the coma might not be a direct result of the GPDs. In contrast, the dialeptic state in NCSE without coma is a true manifestation of the epileptiform discharges, hence warranting treatment with antiseizure medications. In this report, a case of NCSE with coma is described caused by ceftriaxone-induced neurotoxicity and its electroclinical characteristics are compared with a case of NCSE without coma in a patient with chronic focal epilepsy.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"555-558"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Unsatisfactory Accuracy and Inconsistent Inter-Rater Reliability Among Electroencephalographers in Identifying Epileptic Spasms. 脑电图学家在识别癫痫性痉挛方面的准确性不理想和可靠性不一致。

IF 1.8 4区医学

Journal of Clinical Neurophysiology Pub Date : 2026-09-01 Epub Date: 2025-12-23 DOI: 10.1097/WNP.0000000000001234

Wen Wang, Lin Wan, Jian Chen, Yan Zhao, Zong Wang, Yuying Fan, Guangshuang Lu, Hongjie Wang, Tong Liu, Weike Cheng, Yang Xu, Yuan Zhang, Bo Zhang, Lijun Fu, Guang Yang

{"title":"Unsatisfactory Accuracy and Inconsistent Inter-Rater Reliability Among Electroencephalographers in Identifying Epileptic Spasms.","authors":"Wen Wang, Lin Wan, Jian Chen, Yan Zhao, Zong Wang, Yuying Fan, Guangshuang Lu, Hongjie Wang, Tong Liu, Weike Cheng, Yang Xu, Yuan Zhang, Bo Zhang, Lijun Fu, Guang Yang","doi":"10.1097/WNP.0000000000001234","DOIUrl":"10.1097/WNP.0000000000001234","url":null,"abstract":"Purpose: It is widely believed that electroencephalographers can identify epileptic spasms (ES) accurately. However, additional research is needed to verify this assumption, especially because some ES can be subtle, involving only facial movements, such as eye rolling.Methods: The EEG data of 22 patients diagnosed with ES (whether or not it is diagnosed as infantile epileptic spasm syndrome) were evaluated by 6 senior electroencephalographers. The content included judgments of the presence or absence of ES throughout the entire examination process for each patient and in segmented pages every 4 seconds and the consistency among electroencephalographers. The inter-rater reliability (IRR) was assessed using the Fleiss kappa statistic.Results: The accuracy of the 6 evaluators for identifying patients with or without ES in the 22-patient data set was 0.727 to 0.90, and the IRR among the 6 raters was moderate (0.45). Moderate IRR was observed among evaluators from tertiary (0.425), and poor IRR was observed among evaluators from nontertiary (0.399) centers. For the 4-second segmented pages, the accuracy for identifying ES in the 22 patients by the 6 evaluators was 0.943 to 1, and the IRR among the 6 evaluators was good agreement (0.63).Conclusions: Omissions in the identification of ES episodes were noted among different electroencephalographers, and IRR regarding whether a patient experienced an ES or whether a single event constituted an ES was found to be unsatisfactory. Identifying ES remains challenging for even experienced electroencephalographers.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"542-547"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anatomy and Structural Connectivity of the Opercula. 上盖的解剖和结构连通性。

IF 1.8 4区医学

Journal of Clinical Neurophysiology Pub Date : 2026-09-01 Epub Date: 2026-06-23 DOI: 10.1097/WNP.0000000000001276

Laurence Charbonneau, Salma Mrichi, Pierre-Olivier Champagne, Guillaume Theaud, Michel W Bojanowski, Sami Obaid

{"title":"Anatomy and Structural Connectivity of the Opercula.","authors":"Laurence Charbonneau, Salma Mrichi, Pierre-Olivier Champagne, Guillaume Theaud, Michel W Bojanowski, Sami Obaid","doi":"10.1097/WNP.0000000000001276","DOIUrl":"10.1097/WNP.0000000000001276","url":null,"abstract":"Summary: The cerebral operculum comprises the cortical folds of the frontal, central, parietal, and temporal lobes that overlie the insula. Although historically described as a simple anatomical \"cover,\" the operculum is now recognized as a morphologically complex periSylvian region embedded within multiple cortico-cortical and cortico-subcortical networks. In this review, a comprehensive synthesis of opercular organization is provided, integrating topographic anatomy, structural connectivity, and vascular supply. The topographic anatomy of the operculum is described in relation to periSylvian sulcal landmarks that define four opercular subregions-the frontal, rolandic (i.e., central), parietal, and temporal opercula-and to the outer Sylvian membrane, which separates the superficial from the medial operculum. Structural connectivity involves well-defined major white matter tracts-including the superior longitudinal, arcuate, inferior fronto-occipital, uncinate, and middle longitudinal fasciculi-alongside operculum-specific associative connections, commissural pathways, and projection fibers. Within this structural framework, the operculum emerges as a critical hub in language, auditory, visual, and gustatory networks, supporting multimodal integration and higher-order processing. Cortical and white matter vascularization of the opercular region is dominated by centripetal branches arising from the M2 to M4 segments of the middle cerebral artery, which supply both superficial and deeper opercular layers. Collectively, the complex morphology, dense structural connectivity, and complex vascular organization of the operculum provide a structural basis for its functional importance and help explain the clinical heterogeneity of opercular epilepsy, including the challenges associated with its diagnosis and surgical management.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"475-489"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Review on the Functional Connectivity of the Human Opercular Cortex. 人类眼皮层功能连通性研究进展。

IF 1.8 4区医学

Journal of Clinical Neurophysiology Pub Date : 2026-09-01 Epub Date: 2026-04-20 DOI: 10.1097/WNP.0000000000001258

Irina Oane, Andrei Barborica, Ioana Mindruta

{"title":"A Review on the Functional Connectivity of the Human Opercular Cortex.","authors":"Irina Oane, Andrei Barborica, Ioana Mindruta","doi":"10.1097/WNP.0000000000001258","DOIUrl":"10.1097/WNP.0000000000001258","url":null,"abstract":"Summary: The opercular cortex is the part of the brain that overlies the insula and is the prolongation of the frontal, parietal, and temporal lobes in the lateral fissure. Over the years, this region has undergone multiple parcellations, and updated, multimodal, large-scale brain atlases highlight up to 16 subregions organized within the frontal, parietal, and temporal opercula. Using complementary methods for brain mapping-such as functional neuroimaging, source connectivity on scalp EEG or magnetoencephalography signals, and effective connectivity measures based on intracranial EEG recordings and cortico-cortical evoked potentials-several connectivity patterns have been identified. The main bidirectional opercular connections are with the insular cortex. The anterior insula is preferentially connected with the temporal and frontal operculum (OpF), whereas the posterior insula is connected to all opercular subdivisions. All three opercular subdivisions are interconnected. The OpF is functionally connected to the cingulate cortex consistent with a role in salience processing and to the temporal basal, temporal neocortex, premotor, and primary sensorimotor regions implicated in language processing. The parietal operculum is functionally connected with the premotor-motor and parietal regions for sensorimotor and vestibular processing. Finally, the temporal operculum is functionally connected with the temporal basal, temporal pole, mesial temporal structures, and parietal cortex supporting auditory, vestibular, and language processing.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"490-494"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Teaching CNP: Active and Passive Knitting Rhythm on EEG. 脑电的主动和被动编织节律。

IF 1.8 4区医学

Journal of Clinical Neurophysiology Pub Date : 2026-09-01 Epub Date: 2026-06-23 DOI: 10.1097/WNP.0000000000001279

Cody L Nathan, Elizabeth E Gerard

引用次数: 0

Direct Electrical Stimulation of the Opercula. 盖部直接电刺激。

IF 1.8 4区医学

Journal of Clinical Neurophysiology Pub Date : 2026-09-01 Epub Date: 2026-05-19 DOI: 10.1097/WNP.0000000000001268

Bingqing Zhang, Wenjing Zhou

{"title":"Direct Electrical Stimulation of the Opercula.","authors":"Bingqing Zhang, Wenjing Zhou","doi":"10.1097/WNP.0000000000001268","DOIUrl":"10.1097/WNP.0000000000001268","url":null,"abstract":"Summary: Direct electrical stimulation (DES) has long been used in patients undergoing epilepsy surgery for two key purposes: functional brain mapping and seizure triggering. In this review, the findings from DES applications to the opercula are synthesized, with the aim of mapping opercular functions and investigating seizure induction. Clinical responses to opercular DES are frequent and diverse, showing a partial segregation with spatial overlap, and exhibiting topographical differences: Emotion is evoked in the most anterior part of frontal operculum, expressive aphasia is the mid-posterior part, followed by oropharyngeal, dysarthria, and gustatory in the central opercula, somatosensory and vestibular in the posterior opercula, and auditory (or rarely visual) in the temporal opercula. No studies have specifically looked at DES-induced seizures from the opercula. Only a small number of studies about insulo-opercular epilepsy have mentioned that DES of the opercula induced seizures. Overall, opercular DES studies converge on the view that the opercula comprise a complex multimodal cortex integrating especially sensorial perception. Each subdivision had a different dominant response to DES, whose organization helps understand the different subgroups of opercular epilepsy.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"524-531"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148329966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial Announcement: Introducing Clinical Neurophysiology Vignettes. 编辑公告：介绍临床神经生理学小插曲。

IF 1.8 4区医学

Journal of Clinical Neurophysiology Pub Date : 2026-09-01 DOI: 10.1097/WNP.0000000000001289

Cody Nathan, Selim Benbadis, Stephan Schuele

引用次数: 0