Journal of Clinical Neurophysiology最新文献

{"title":"Transdural Stimulation for the Identification of a Dehiscent Geniculate Ganglion in Intradural Middle Cranial Fossa Surgery: A Proof-of-Principle Study.","authors":"Sebastian Niedermeyer, Andrea Szelenyi, Christian Schichor","doi":"10.1097/WNP.0000000000001204","DOIUrl":"10.1097/WNP.0000000000001204","url":null,"abstract":"<p><strong>Purpose: </strong>Facial nerve injury is a potential complication in intradural middle cranial fossa surgery, particularly because of dehiscence of the geniculate ganglion, exposing the nerve to thermal injury. Identifying the geniculate ganglion during surgical approaches is crucial for preserving facial nerve function. This study aimed to evaluate the feasibility and efficacy of transdural stimulation in identifying the geniculate ganglion during intradural approaches to improve the preservation of facial nerve function.</p><p><strong>Methods: </strong>We conducted a retrospective analysis on patients who underwent surgery for middle cranial fossa lesions using intraoperative neuromonitoring including facial motor evoked potentials and transdural direct nerve stimulation of the geniculate ganglion, from January 2016 to January 2024.</p><p><strong>Results: </strong>We identified eight consecutive patients with various pathologies of the middle cranial fossa who underwent surgery with direct nerve stimulation of the geniculate ganglion. Specific responses from facial muscles were registered in four out of eight patients, with stimulation intensity varying between 0.5 and 2 mA. None of the patients who underwent surgery with direct nerve stimulation experienced facial palsy. Notably, even when CT scans suggested bony covering of the geniculate ganglion, the facial nerve could still be stimulated.</p><p><strong>Conclusions: </strong>This proof-of-principle study demonstrates that transdural stimulation is a promising technique for identifying the geniculate ganglion during intradural middle cranial fossa surgery. This approach has the potential to improve preservation of facial nerve function and reduce the risk of postoperative facial palsy.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"319-323"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956240","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}

{"title":"Language Mapping by Magnetoencephalography in Patients With Refractory Epilepsy: A Cohort Study.","authors":"Vatsala Lakshmi, Ravindrandh Chowdary Mundlamuri, Mariyappa Narayanan, Rajasekaran Aravind Kumar, Kenchaiah Raghavendra, Ajay Asranna, Lakshminarayanapuram Gopal Vishwanathan, Karthik Kulanthaivelu, Jitender Saini, Rose Dawn Bharath, Sanjib Sinha","doi":"10.1097/WNP.0000000000001215","DOIUrl":"10.1097/WNP.0000000000001215","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to develop and validate magnetoencephalography paradigms for presurgical language mapping in patients with drug-resistant epilepsy.</p><p><strong>Methods: </strong>This prospective observational study of 30 patients with drug-resistant epilepsy included two trials involving visual picture naming and auditory word recognition tasks. Language activation was analyzed using dynamic statistical parametric mapping for beta desynchronization and a fixed time window (350-500 ms). Concordance across trials, analysis methods, and functional MRI comparisons were also assessed.</p><p><strong>Results: </strong>Primary visual and auditory cortex activation occurred in 66.6 and 80% of the patients, respectively. Language-specific area activation was observed in 56.7% of the picture naming task patients and 70% of the auditory word recognition task patients. Lateralization was predominantly left sided in 41.1% (picture naming) and 61.9% (auditory word recognition) of cases, with some bihemispheric patterns. Beta desynchronization and fixed-time window analyses had comparable detection rates but with limited concordance. Magnetoencephalography-functional MRI lateralization agreement was 56.25% (Cohen kappa = 0.15). No significant correlations were found between the epilepsy parameters and language activation.</p><p><strong>Conclusions: </strong>Magnetoencephalography provides valuable insights into language localization and functional reorganization in patients with epilepsy. Although task-specific activations highlight their utility, further studies with larger cohorts and gold-standard validations are needed to enhance their clinical applicability in presurgical planning.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"305-312"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280212","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}

{"title":"High-Gain Analysis of Postictal sEEG Suppression Identifies Otherwise Invisible Multifrequency Activity, Including Persisting Ictal Discharges.","authors":"Kameel M Karkar, Sreekanth Koneru, Amy Werry-McFarlin, Meera C Karkar, Crystal D Wiedner, Jayandra J Himali, Alexander Papanastassiou, Charles Akos Szabo","doi":"10.1097/WNP.0000000000001221","DOIUrl":"10.1097/WNP.0000000000001221","url":null,"abstract":"<p><strong>Purpose: </strong>Recent studies have challenged the assumption that brain activity is absent or only slow postictally, with reports of higher frequency activity. However, there are conflicting reports as to whether such activity is present under significant postictal suppression. To address this question, we performed a high-gain review combined with spectrographic analysis of postictal stereo-EEG suppression.</p><p><strong>Methods: </strong>The postictal stereo-EEG of six focal to bilateral tonic-clonic seizures was reviewed both at standard gain (50-100 μV/mm) and at ultra-high gain (2-5 μV/mm). Time-frequency spectrographic analysis was performed of one channel in the seizure onset zone during the periictal period. Power of the gamma frequency band was quantified in the first 15 seconds postictally and compared with a preictal baseline.</p><p><strong>Results: </strong>(1) Review at ultra-high gain identified an otherwise invisible evolving mixed-frequency background including high-frequency oscillatory activity, continuing ictal activity in one seizure, and early sharp activity (83.33%). (2) Activity was present despite significant suppression (18.46 μV in the seizure onset zone channel). (3) Time-frequency spectrogram revealed a steep drop of EEG power postictally, including gamma power, yet power was not completely absent.</p><p><strong>Conclusions: </strong>(1) Although the stereo-EEG appeared suppressed postictally, the combination of direct review at ultra-high gain and spectrographic analysis identified otherwise invisible low-power activity. (2) We found intermittent high-frequency oscillatory activity, early postictal sharp activity, as well as the first report of persistent ictal discharges under apparent suppression. (3) Unmasking this activity could help explain postictal seizure-like behaviors and would challenge how the onset of the postictal state is declared.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"296-304"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742780","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}

{"title":"Application of Electrophysiologic Monitoring in Contralateral C7 Nerve Transfer Surgery.","authors":"Chengyuan Ji, Hao Liu, Hongjun Zhu, Hongbin Ni, Jiangang Liu","doi":"10.1097/WNP.0000000000001205","DOIUrl":"10.1097/WNP.0000000000001205","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the intraoperative localization and prognostic utility of electrophysiologic monitoring for upper limb and hand muscle groups during contralateral C7 nerve transfer surgery.</p><p><strong>Methods: </strong>In this retrospective, dual-center study, patients with spastic hemiparesis of a single upper limb who underwent contralateral C7 nerve transfer between July 2022 and November 2023 at the First Affiliated Hospital of Soochow University and Nanjing Drum Tower Hospital were included. Sensory, motor, and muscle tone changes were assessed using free electromyography, compound muscle action potentials, somatosensory evoked potentials, and transcranial electrical stimulation motor evoked potentials.</p><p><strong>Results: </strong>Ten patients (eight males and two females; mean age: 54 ± 10.7 years) were included. Free electromyography demonstrated 100% accuracy in detecting nerve traction. Stimulation of the C7 nerve elicited 100% positive compound muscle action potential responses in the triceps brachii, extensor carpi radialis brevis, and flexor carpi ulnaris muscles. All patients exhibited somatosensory evoked potential wave amplitude reductions greater than 50%, whereas latency changes were observed in 10% of cases.</p><p><strong>Conclusions: </strong>Real-time free electromyography and triggered stimulation enabled accurate localization of C5-C8 nerve roots. Somatosensory evoked potential and transcranial electrical stimulation motor evoked potential monitoring were predictive of postoperative sensory and motor function in the unaffected upper limb.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"324-331"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956279","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}

{"title":"Ictal Bruxism in Temporal Lobe Epilepsy: Intracranial EEG Connectivity Study.","authors":"Lilly W Tang, Udeept Sindhu, Jorge Gonzalez-Martinez, Thandar Aung","doi":"10.1097/WNP.0000000000001232","DOIUrl":"10.1097/WNP.0000000000001232","url":null,"abstract":"<p><strong>Summary: </strong>Ictal bruxism is a rare motor manifestation in temporal lobe epilepsy with unclear network underpinnings. We report the first case demonstrating SEEG-guided network characterization of ictal bruxism in a 55-year-old man with drug-resistant temporal lobe epilepsy who continued to experience stereotyped seizures with rhythmic teeth grinding after a failed anterior temporal lobectomy. SEEG recorded one spontaneous and two stimulation-induced seizures sampling from the superior temporal gyrus, anterior ventral insula (aVInsula), and nine additional regions of interest. Recordings identified seizures originating from the superior temporal gyrus with early propagation to the anterior insulo-opercular regions at bruxism onset. Direct cortical stimulation of both superior temporal gyrus and aVInsula reproduced seizures and bruxism, confirming causal network associations. Time-frequency and coherence analyses demonstrated significant increases in beta and gamma band synchrony between the superior temporal gyrus /AVINSULA and opercular regions, particularly the pars opercularis and frontoparietal operculum, aligning with bruxism onset across all three seizures. Notably, bruxism occurred in the absence of ipsilateral mesial temporal structures, setting it apart from other oro-alimentary automatisms, such as lip smacking, that exhibit theta-predominant coherence within mesial temporal networks. This case highlights ictal bruxism as a network-level phenomenon in temporal lobe epilepsy that warrants classification distinct from typical oro-alimentary automatisms to optimize seizure localization and surgical outcomes.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"368-372"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145809957","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}

{"title":"S2, S3, and S4 Sacral Dermatomal Evoked Potentials: Technical Parameters and Normative Values.","authors":"Prasad Malladi, Llwyd Orton, Sara Simeoni, Jalesh Panicker","doi":"10.1097/WNP.0000000000001206","DOIUrl":"10.1097/WNP.0000000000001206","url":null,"abstract":"<p><strong>Purpose: </strong>The existing literature on the sacral dermatomal evoked potentials (dSEPs) is limited. This study aims to develop stimulating parameters and establish normative values for S2, S3, and S4 sacral dermatomes in healthy adult populations.</p><p><strong>Methods: </strong>Twenty healthy adult volunteers were enrolled in the study. The study was ethically approved, and written consent for participation was provided. All participants underwent tibial, pudendal, S2, S3, and S4 dSEPs. Stimulating and recorded parameters were established for all evoked potentials. P40 latency, amplitude, and interpeak parameters were calculated for each waveform. A comparison was made between tibial, pudendal somatosensory evoked potentials, and all sacral dSEPs. Normative values were generated for sacral dSEPs based on various height, age, and Body Mass Index (BMI) parameters.</p><p><strong>Results: </strong>The sacral dSEPs were well tolerated and recorded in all participants. S2 latency was mildly influenced by age and height, while S3 and S4 latencies were unaffected by age or height. BMI does not affect the S2 and S3 latencies but mildly affects the S4 latency. Sacral dSEP latencies were comparable with pudendal SEPS but not with the tibial somatosensory evoked potential.</p><p><strong>Conclusions: </strong>The S2, S3, and S4 sacral dSEPs can be used as diagnostic tools to evaluate sacral nerve lesions such as cauda equina syndrome and Tarlov cysts, complementary to pudendal and tibial somatosensory evoked potentials.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"340-346"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Electric Source Imaging Approach Demonstrating Diagnostic Value of Nasopharyngeal Electrodes in Temporal Lobe Epilepsy.","authors":"Yun Ho Choi, Taeik Jang, Soo Hwan Yim, Kyoung Heo","doi":"10.1097/WNP.0000000000001213","DOIUrl":"10.1097/WNP.0000000000001213","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the different regions covered by nasopharyngeal (NPEs) and anterior temporal (anterior temporal electrodes [ATEs]) electrodes in assessing temporal lobe epilepsy, to overcome the limitations of the 10 to 20 electroencephalography (EEG) in diagnosing the basal and mesial temporal regions.</p><p><strong>Methods: </strong>EEG data from 229 patients diagnosed with temporal lobe epilepsy were simultaneously analyzed with attached NPEs and ATEs. In case of discrepancies in EEG interpretation, a consensus interpretation was reached among three epilepsy experts. Spike detection was conducted using the Curry9 program for secondary analysis of electric source localization, with source location performed using standard brain MRI data.</p><p><strong>Results: </strong>In total, 2,721 interictal epileptiform discharges (IEDs) from 175 patients were analyzed. Of these, 734 IEDs from 48 patients were detected exclusively with NPEs, while 1,987 IEDs from 127 patients were detected simultaneously by both NPEs and the standard international 10 to 20 electrodes system supplemented with ATEs, respectively. The former IEDs exhibited clustering dipoles in the basal and mesial temporal regions, while the latter were localized solely to the frontotemporal and lateral temporal regions.</p><p><strong>Conclusions: </strong>Nasopharyngeals can identify IEDs in the mesial and basal temporal region that cannot be detected by ATEs. Nasopharyngeals offer additional diagnostic value in regions not confirmed by the existing 10 to 20 EEG electrode system, including those covered by ATE.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"289-295"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13124259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of Transcranial Motor-Evoked Potential Linked Quadripolar Montage.","authors":"Cinira Diogo, Anthony Clanton, Stephen Holmberg, Brooke E Callahan, Adam T Doan","doi":"10.1097/WNP.0000000000001218","DOIUrl":"10.1097/WNP.0000000000001218","url":null,"abstract":"<p><strong>Purpose: </strong>The linked quadripolar montage for transcranial electric motor-evoked potentials (qTceMEP) consists of four stimulation electrodes: two linked anodes and two linked cathodes. This montage has grown in popularity because it can result in a larger compound muscle action potential amplitude compared with the conventional bipolar montage. Despite the increasing number of centers adopting qTceMEP, no studies have investigated patient safety to date. The aim of this study is to evaluate the safety profile of qTceMEP.</p><p><strong>Methods: </strong>A total of 3,806 spine surgeries performed at a single institution using intraoperative transcranial electrical motor-evoked potentials (TceMEP) were reviewed. Among them, 1,196 were performed using bipolar TceMEP, while the remaining 2,610 cases were performed using qTceMEP. The incidence of intraoperative seizure, unexpected cardiac events, bite/oral injuries, and movement-related injuries was compared between the two groups, bipolar TceMEP and qTceMEP. The statistical analysis was performed using MedCalc.</p><p><strong>Results: </strong>No seizure activity, cardiac anomalies, or adverse events related to intracranial and cardiac implant devices were reported in either group. The incidence of intraoperative oral injuries was 0.4% in the bipolar TceMEP group and 0.5% in the qTceMEP group. The difference in the incidence of oral injuries between the two groups was not statistically significant.</p><p><strong>Conclusions: </strong>The use of qTceMEP does not increase or decrease a patient's risk of intraoperative injury. Both bipolar TceMEP and qTceMEP are safe, presenting a small incidence of oral injuries and no other adverse side effects.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":"313-318"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308206","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}

{"title":"Estimating Reference Limits for Motor Conduction Block Using Latency Adjustment and a Modified MeRef Model.","authors":"Thorbjørn S Engedal, Erisela Qerama, Jón Á Benediktsson, Oliver R Kjeldsen, Birger Johnsen, Sigbjørn Hokland","doi":"10.1097/WNP.0000000000001252","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001252","url":null,"abstract":"<p><strong>Introduction: </strong>Current thresholds for motor conduction block on nerve conduction studies are primarily based on expert opinion and fail to consider individual patient- or nerve-specific characteristics. In this article, we aimed to improve diagnostic accuracy for identifying partial motor conduction block and determine the influence of latency difference (LD) between proximal and distal stimulation on amplitude decay in unaffected nerves.</p><p><strong>Methods: </strong>We developed the multivariate extrapolated truncated fit model to establish reference limits for amplitude decay depending on LD using existing nerve conduction studies data and compared these with existing literature values and with published thresholds for conduction block.</p><p><strong>Results: </strong>A total of 67,266 investigations of the forearm or lower leg segments of the median, ulnar, peroneal, and tibial nerves were included. The mean multivariate extrapolated truncated fit upper limits (model +2SD) for amplitude decay in nerves with normal distal amplitude/decreased distal amplitude were: Median 14.3%/24.1%, Ulnar 17.5%/34.4%, Peroneal 27.7%/41%, and Tibial 46%/57.1%. For the four nerves, we observed 1.7% to 5.1% increases in amplitude decay per ms increase in LD. Contrary to the multivariate extrapolated truncated fit reference limits, existing thresholds for conduction block produced inconsistent positive rates between nerves with a high risk of false positive and negative results.</p><p><strong>Conclusions: </strong>Amplitude decay on nerve conduction studies was dependent on LD, and the multivariate extrapolated truncated fit model showed promise as a tool to create reference limits from large data sets. Reference limits adjusted for LD could improve diagnosis of inflammatory polyneuropathies and other conditions with conduction block.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529357","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}

{"title":"Magnetoencephalography as a Novel Tool for Prenatal Diagnosis of Fetal Seizures.","authors":"Dayna D Whitcombe, Diana Escalona-Vargas, Hari Eswaran, Heather Moody, Luis Mercado, Nafisa K Dajani, Debopam Samanta","doi":"10.1097/WNP.0000000000001253","DOIUrl":"10.1097/WNP.0000000000001253","url":null,"abstract":"<p><strong>Summary: </strong>Fetal seizures represent one of the rarest phenomena in prenatal medicine, with fewer than 50 documented cases. Diagnosis has traditionally relied on maternal reports and ultrasound visualization of abnormal movements, lacking the neurophysiologic confirmation available in neonatal care. This case report presents the first neurophysiologic assessment of fetal seizures using fetal magnetoencephalography (fMEG), demonstrating a novel diagnostic approach for prenatal neurologic evaluation. A 22-year-old primigravida with controlled epilepsy presented with a fetus showing severe growth restriction and multiple anomalies at 23 weeks gestation. At 32 weeks, repetitive rhythmic jerking movements suggested in utero seizures and were confirmed with real-time ultrasound. fMEG was performed using the SQUID Array for Reproductive Assessment (SARA) system, revealing immature patterns indicative of encephalopathy with alternating periods of severe bilateral suppression and low-amplitude activity. Bursts lasting up to 6 seconds coincided with erratic body movements confirmed by actogram. The infant was delivered at 37 weeks weighing 1,200 g and continued to exhibit myoclonic and clonic seizures postnatally. Postmortem whole exome sequencing identified biallelic pathogenic variants in PSAT1, confirming Neu-Laxova syndrome. The infant died on the fifth day of life after transition to comfort care. This case demonstrates the feasibility of direct neurophysiologic assessment of fetal brain activity using fMEG, providing objective confirmation of fetal seizures for the first time. The technology offers potential for distinguishing true fetal seizures from other conditions that mimic seizure-like movements, enabling more accurate prenatal counseling and informed decision making. This represents a significant advancement in prenatal neurologic assessment, with implications for early diagnosis and targeted interventions.</p>","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512314","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}