Journal of Clinical Neurophysiology最新文献_第3页

Clinical Implications of Small Sharp Spikes in Mesial Temporal Lobe Epilepsy: Controversies and Opportunities. 内侧颞叶癫痫小尖峰的临床意义：争议与机遇。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-04-30 DOI: 10.1097/WNP.0000000000001165

Naoum P Issa, Shasha Wu, Sandra Rose, Zachary Osborn, James X Tao

{"title":"Clinical Implications of Small Sharp Spikes in Mesial Temporal Lobe Epilepsy: Controversies and Opportunities.","authors":"Naoum P Issa, Shasha Wu, Sandra Rose, Zachary Osborn, James X Tao","doi":"10.1097/WNP.0000000000001165","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001165","url":null,"abstract":"Summary: Mesial temporal lobe epilepsy (mTLE) is the most prevalent type of focal epilepsy, marked by significant comorbidities including memory impairment, depression, panic, and bipolar disorders, rendering it highly incapacitating. However, early diagnosis remains challenging due to a prolonged latent period, subtle prodromal symptoms, and scant scalp EEG manifestation of hippocampal epileptiform activity. Consequently, identification of early biomarkers for mTLE is crucial. Small sharp spikes (SSSs) have traditionally been considered benign EEG patterns as they are inconsistently correlated with epilepsy, almost equally occurring in patients with and without epilepsy. Recent studies, however, have demonstrated a time-locked association between SSS and hippocampal spikes in patients with mTLE, which strongly suggests that SSS represent pathologic EEG biomarkers of mTLE, challenging the prevailing belief that SSS are benign EEG patterns. Nonetheless, the clinical significance of SSS remains controversial, particularly in patients without a diagnosis of epilepsy. Considering that patients without a diagnosis of epilepsy displaying SSS often exhibit prodromal symptoms reminiscent of those seen in mTLE, prompting EEG investigation, which raises the possibility that these patients are likely in the latent period of mTLE and suspicious for epilepsy. Therefore, SSS might be early biomarkers for mTLE. A correlation between SSS and hippocampal spikes might also exist among these patients. The implication of SSS as early EEG biomarkers is profound, enabling early diagnosis and providing a window for antiseizure and disease-modifying interventions for patients with mTLE. Here, we critically reappraise the clinical significance of SSS and explore the perspectives of SSS as early pathologic EEG markers for mTLE.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063871","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

Response to the Letter to the Editor. 对给编辑的信的回应。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-04-24 DOI: 10.1097/WNP.0000000000001167

Wei-Chih Yeh, Chung-Yao Hsu

引用次数: 0

Early Versive Head Turn Semiology Related to Ipsilateral Posterior Cingulate: A Case Report and Literature Review. 与同侧后扣带相关的早期逆转头转符号学：1例报告及文献复习。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-04-21 DOI: 10.1097/WNP.0000000000001162

Stephen Orr, Stephen Glass, Thandar Aung

{"title":"Early Versive Head Turn Semiology Related to Ipsilateral Posterior Cingulate: A Case Report and Literature Review.","authors":"Stephen Orr, Stephen Glass, Thandar Aung","doi":"10.1097/WNP.0000000000001162","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001162","url":null,"abstract":"Summary: Versive head turns, characterized by forced and involuntary head movements leading to sustained unnatural positioning, are consistently recognized as reliable indicators of contralateral hemisphere involvement. This study presents a case demonstrating ictal semiology marked by the simultaneous onset of blurred vision, spinning, distorted voice, and an early left-versive head turn. The versive head turn semiology correlated with rapid ictal discharges in the ipsilateral posterior cingulate gyrus and was reproducible with direct cortical stimulation during stereoelectroencephalography evaluation. A comprehensive literature review (from 1994 to 2023) was conducted to investigate the relationship between early ictal head version semiology, either contralateral or ipsilateral, and localization of the ictal onset regions. Analysis of 105 patients revealed that 87% exhibited early contralateral head version noted from seizures originating from anterior regions (frontal lobe or anterior/midcingulate regions), compared with 56% in posterior regions (parietal, occipital, or posterior cingulate areas) and 44% in the temporal lobe. When comparing anterior to temporal regions, the anterior group had an eightfold higher likelihood of contralateral versive seizures (odds ratios = 8.1, 95% confidence interest, 1.72-38.35, P = 0.0038), indicating a significantly higher likelihood of ipsilateral early head version in temporal lobe seizures. There was no significant difference in the likelihood of ipsilateral head version between the anterior and posterior groups or between the posterior and temporal groups. These findings underscore the need for cautious interpretation of early head versive signs alone as indicators of contralateral hemisphere epileptogenic zone, advocating for consideration of ipsilateral hemisphere epileptogenic zone involvement in presurgical hypotheses, in selected patients.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973435","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

Response to: Subclinical Epileptiform Discharge in Patients With Alzheimer Dementia: A Systematic Review and Meta-Analysis. 对阿尔茨海默病患者亚临床癫痫样放电的反应：系统回顾和荟萃分析。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-04-17 DOI: 10.1097/WNP.0000000000001166

Selim R Benbadis

引用次数: 0

Association of Time to Continuous EEG Initiation With Outcomes in Critically Ill Patients. 危重患者持续脑电图开始时间与预后的关系。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-04-16 DOI: 10.1097/WNP.0000000000001161

Muhammad A Haider, Mohammad H Khalil, Marta B Fernandes, Michael B Westover, Sahar F Zafar

{"title":"Association of Time to Continuous EEG Initiation With Outcomes in Critically Ill Patients.","authors":"Muhammad A Haider, Mohammad H Khalil, Marta B Fernandes, Michael B Westover, Sahar F Zafar","doi":"10.1097/WNP.0000000000001161","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001161","url":null,"abstract":"Purpose: Continuous electroencephalography (cEEG) is used in the critical care setting for seizure detection and treatment, sedation management, and ischemia detection. Further evidence is needed to support whether early cEEG use can improve outcomes. We examined whether time from admission to cEEG initiation affects outcomes.Methods: This is a single-center cohort study of critically ill adults (age > 18 years) who underwent cEEG monitoring within 7 days of admission from January to December 2019. Patients with anoxic brain injury were excluded. Time (hours) from admission to cEEG was recorded. Outcomes were in-hospital mortality and poor discharge modified Rankin Score (4-6). Results are reported as median [quartile range] and odds ratio (OR) [confidence intervals, CI].Results: In total, 464 patients met eligibility. Median time to cEEG was 23 hours [13, 52]. On multivariable analysis, increasing time to cEEG was associated with discharge mortality (OR, 1.006 [CI, 1.0002-1.013], 0.1%/hour [CI, 0.02-0.2]) and poor outcome (OR, 1.013 [CI, 1.005-1.020], 0.2%/hour [CI, 0.07-0.3]). Median time to cEEG initiation in patients with clinical concern for seizures/status at presentation (n = 121) was 12 hours [6, 17] and in patients without clinical concern for seizures at presentation (n = 343) was 31 hours [18, 66]. In patients without clinical concern for seizures/status epilepticus at presentation, time to cEEG continued to be associated with mortality (OR, 1.007 [CI, 1.001-1.014)] and poor outcome (OR, 1.012 [CI, 1.003-1.021]).Conclusions: Increasing time to cEEG initiation was associated with higher mortality and worse outcomes. We hypothesize earlier cEEG results in timely interventions including treatment escalation and de-escalation that may improve outcomes.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027128","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

Acute Disruption of Cortical Epileptiform Discharges With Thalamic Stimulation. 丘脑刺激对皮质癫痫样放电的急性破坏。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-04-16 DOI: 10.1097/WNP.0000000000001163

Sisira Yadala, Salman Zahoor, Diana Escalona-Vargas, Viktoras Palys

{"title":"Acute Disruption of Cortical Epileptiform Discharges With Thalamic Stimulation.","authors":"Sisira Yadala, Salman Zahoor, Diana Escalona-Vargas, Viktoras Palys","doi":"10.1097/WNP.0000000000001163","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001163","url":null,"abstract":"Summary: Thalamic neuromodulation has emerged as a promising treatment for drug-resistant epilepsy, with deep brain stimulation of the anterior nucleus of the thalamus currently Food and Drug Administration approved for this purpose. The Stimulation of the Anterior Nucleus of Thalamus for Epilepsy trial demonstrated that chronic anterior nucleus of the thalamus stimulation can significantly reduce seizure burden. In addition, the centromedian nucleus is gaining interest as a potential neuromodulation target among epilepsy experts, though its use remains off-label. Effective selection of neuromodulation targets requires reliable biomarkers, ideally with real-time feedback, yet studies on the acute effects of thalamic stimulation on epileptiform activity remain limited. Our cases provide novel evidence of acute suppression of epileptiform activity in the cerebral cortex-specifically, the cingulate and insular cortices-after anterior nucleus of the thalamus and centromedian nucleus stimulation, respectively, through stereoelectroencephalography electrodes. This finding enhances our understanding of cortical responses to thalamic stimulation and supports its therapeutic potential in both chronic and acute settings. Emerging research suggests that other thalamic nuclei may also play a role in managing epilepsy originating from different brain regions. We emphasize that routine stereoelectroencephalography implantation in thalamic nuclei may provide valuable clinical insights and aid in selecting the optimal target for stimulation. This case mini-series contributes to the growing evidence supporting the therapeutic potential of thalamic neuromodulation in epilepsy treatment.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993887","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

Beyond Jitter: Spike Count Analysis for Differentiating Botulinum Toxin and Myasthenic Effects on Neuromuscular Function. 超越抖动：刺突计数分析用于区分肉毒毒素和肌无力对神经肌肉功能的影响。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-04-16 DOI: 10.1097/WNP.0000000000001164

Nur Türkmen, Muhammed Yıldırım, Gönül Vural

{"title":"Beyond Jitter: Spike Count Analysis for Differentiating Botulinum Toxin and Myasthenic Effects on Neuromuscular Function.","authors":"Nur Türkmen, Muhammed Yıldırım, Gönül Vural","doi":"10.1097/WNP.0000000000001164","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001164","url":null,"abstract":"Purpose: Single-fiber electromyography is the most sensitive tool for diagnosing neuromuscular diseases but is limited in differentiating between presynaptic and postsynaptic neuromuscular junction involvement with increased jitter. With rising botulinum toxin (BoNT) use for therapeutic and cosmetic applications, referrals for electromyography because of myasthenia-like symptoms have increased, complicating differential diagnosis. This study examines whether spike count measurements from single-use concentric needle electrodes can distinguish BoNT effects from neuromuscular junction diseases such as myasthenia gravis.Methods: We analyzed 49 patients and 26 controls, assessing jitter and spike count with concentric needle electrodes in the frontalis muscle. Groups included those exposed to BoNT (>1 month and <1 month prior) and patients with myasthenia gravis, with normal jitter controls for comparison. Data were analyzed for jitter, spike count, and additional electrophysiologic parameters using standard statistical tests (P < 0.05).Results: Results showed that spike counts were significantly different across the groups. Higher spike counts with lower single spike frequency were found in patients with BoNT exposure >1 month, suggesting a differentiation point from primary neuromuscular involvement. In contrast, patients with myasthenia gravis exhibited increased jitter without increased spike counts.Conclusions: These findings indicate that spike count analysis with concentric needle electrodes may aid in differentiating iatrogenic BoNT effects from primary neuromuscular junction disorders, such as myasthenia gravis. However, further studies with larger sample sizes are necessary to validate these results.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020882","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

Book Review for Atlas of EEG in Critical Care, 2nd Edition. 书评脑电图图集在重症监护，第二版。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-04-14 DOI: 10.1097/WNP.0000000000001158

Aaron F Struck

引用次数: 0

Olfactory Evoked Potential Produced by Electrical Stimulation for Monitoring Olfactory Function During Endonasal Endoscopic Surgery: A Preliminary Study. 鼻内窥镜手术中电刺激产生的嗅觉诱发电位监测嗅觉功能的初步研究。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-04-02 DOI: 10.1097/WNP.0000000000001160

Feifan Ouyang, Tianci Feng, Yajing Wang, Weiluo Huang, Laiquan Zou, Yun Ma, Peng Tian, Xiang Liu

{"title":"Olfactory Evoked Potential Produced by Electrical Stimulation for Monitoring Olfactory Function During Endonasal Endoscopic Surgery: A Preliminary Study.","authors":"Feifan Ouyang, Tianci Feng, Yajing Wang, Weiluo Huang, Laiquan Zou, Yun Ma, Peng Tian, Xiang Liu","doi":"10.1097/WNP.0000000000001160","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001160","url":null,"abstract":"Purpose: The aim of this study is to develop an intraoperative olfactory monitoring system using olfactory evoked potential produced by electrical stimulation. Furthermore, the study seeks to ascertain the feasibility and safety of olfactory evoked potential. This study lays the groundwork for safeguarding olfactory function during surgical procedures.Methods: We provided a detailed description of the procedure involving electrical stimulation of the olfactory mucosa to induce olfactory evoked potentials during endonasal endoscopic surgery under general anesthesia. This study enrolled 20 patients undergoing endonasal endoscopic surgery. Before surgery, all patients reported no olfactory complaints, and T&T olfactometry did not detect any olfactory disorders. Olfactory evoked potentials were recorded from various regions of the nasal mucosa and followed by analysis of waveform differentiation, latencies, and amplitudes.Results: Typical \"N1-P1-N2\" three-phase waves, consistent with the waveforms of olfactory evoked potentials recorded in previous studies, were collected from the olfactory mucosa in each case. No significant alteration was observed in the patients' olfactory function pre- and postsurgery. The latencies of the \"N1-P1-N2\" waves recorded during the operation were 12.2 ± 6.9 ms, 28.9 ± 10.0 ms, and 47.1 ± 11.6 ms, respectively, whereas the amplitudes of the \"N1-P1\" and \"P1-N2\" waves measured 0.9 and 0.6 μV, respectively.Conclusions: Intraoperative olfactory monitoring through olfactory evoked potential produced by electrical stimulation is achievable and safe.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764155","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

Shear Wave Velocity of the Thenar Muscle Is Associated With the Neurophysiologic Severity of Carpal Tunnel Syndrome. 大鱼际肌肉的横波速度与腕管综合征的神经生理严重程度有关。

IF 2.3 4区医学

Journal of Clinical Neurophysiology Pub Date : 2025-03-19 DOI: 10.1097/WNP.0000000000001157

Henri Grönfors, Katri Mäkelä, Sari-Leena Himanen

{"title":"Shear Wave Velocity of the Thenar Muscle Is Associated With the Neurophysiologic Severity of Carpal Tunnel Syndrome.","authors":"Henri Grönfors, Katri Mäkelä, Sari-Leena Himanen","doi":"10.1097/WNP.0000000000001157","DOIUrl":"https://doi.org/10.1097/WNP.0000000000001157","url":null,"abstract":"Purpose: Aim of the study was to examine the associations between abductor pollicis brevis (APB) muscle stiffness evaluated by shear wave elastography and electrodiagnostic study findings in patients with carpal tunnel syndrome. The association between shear wave elastography and APB muscle echogenicity was also examined.Methods: This prospective study included patients who were referred to electrodiagnostic studies because of upper limb symptoms. The electrodiagnostic studies consisted of nerve conduction studies and needle-electromyography. Abductor pollicis brevis muscle shear wave velocity was measured, and muscle echogenicity assessed using the Heckmatt grading scale.Results: In total, 97 hands were included in the nerve conduction studies. Of these, 53 APB muscles were further examined with needle-electromyography. Shear wave velocity correlated positively with the neurophysiologic severity of carpal tunnel syndrome (r = 0.449, P = 0.028, N = 26). Mean shear wave velocity was faster in the APB muscles with neurogenic findings (mean 2.72 m/second, ±SD 0.36) than muscles with normal findings (2.48 m/second, ±SD 0.34, P = 0.036). In receiver operating characteristic analysis, the best shear wave velocity cutoff value was 2.66 m/second. With this cutoff value, the sensitivity was 0.692, while the 1-specificity was 0.233. Only seven APB muscles showed increased echogenicity.Conclusions: Shear wave velocity of APB muscle is positively associated with the neurophysiologic severity of carpal tunnel syndrome. Carpal tunnel syndrome-related axonal damage also seems to increase shear wave velocity in APB muscle; however, according to the receiver operating characteristic analysis, the method is not yet suitable for clinical use to define muscle denervation. The findings of this study show that shear wave elastography has potential as an additional clinical tool in the diagnostics of carpal tunnel syndrome.","PeriodicalId":15516,"journal":{"name":"Journal of Clinical Neurophysiology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657376","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