Marshall F Wilkinson, Jennyfer P Galdino Chaves, Miguel Vega Arroyo, Mohammed Zarrabian
{"title":"Repeated L5 Nerve Root Compromise Detected with Motor Evoked Potentials (MEP), but Not Electromyography (EMG): A Case Report.","authors":"Marshall F Wilkinson, Jennyfer P Galdino Chaves, Miguel Vega Arroyo, Mohammed Zarrabian","doi":"10.1080/21646821.2024.2312098","DOIUrl":"10.1080/21646821.2024.2312098","url":null,"abstract":"<p><p>We report a case where neuromonitoring, using motor evoked potentials (MEP), detected an intraoperative L5 nerve root deficit during a lumbosacral decompression and instrumented fusion procedure. Critically, the MEP changes were not preceded nor accompanied by any significant spontaneous electromyography (sEMG) activity. Presumptive L5 innervated muscles, including tibialis anterior (TA), extensor hallucis longus (EHL) and gluteus maximus, were targets for nerve root surveillance using combined MEP and sEMG techniques. During a high-grade spondylolisthesis correction procedure, attempts to align a left-sided rod resulted in repeated loss and recovery cycles of MEP from the TA and EHL. No accompanying EMG alerts were associated with any of the MEP changes nor were MEP variations seen from muscles innervated above and below L5. After several attempts, the rod alignment was achieved, but significant MEP signal decrement (72% decrease) remained from the EHL. Postoperatively, the patient experienced significant foot drop on the left side that recovered over a period of 3 months. This case contributes to a growing body of evidence that exclusive reliance on sEMG for spinal nerve root scrutiny can be unreliable and MEP may provide more dependable data on nerve root patency.</p>","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":" ","pages":"24-32"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029110","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":"The Maureen Berkeley Award and The Theda Sannit Outstanding Educator Award.","authors":"","doi":"10.1080/21646821.2023.2289871","DOIUrl":"https://doi.org/10.1080/21646821.2023.2289871","url":null,"abstract":"","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":"63 4","pages":"292"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811238","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}
Janine Gregory, Kent Rice, Kevin McCarthy, Carl Glover, Samuel Johnson, Adam Doan
{"title":"<b>Letter to the Editor Regarding:</b> \"Guidelines for Qualifications of Neurodiagnostic Personnel: A Joint Position Statement of the American Clinical Neurophysiology Society, the American Association of Neuromuscular & Electrodiagnostic Medicine, the American Society of Neurophysiological Monitoring, and ASET - The Neurodiagnostic Society\".","authors":"Janine Gregory, Kent Rice, Kevin McCarthy, Carl Glover, Samuel Johnson, Adam Doan","doi":"10.1080/21646821.2023.2246118","DOIUrl":"10.1080/21646821.2023.2246118","url":null,"abstract":"","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":"63 4","pages":"293-295"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810962","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}
Sheba Anna Shaji, Aparna E G, Biji Bahuleyan, Fathima Noushad, Sanu J Vincent, Aswathy Suresh, Ashalatha Radhakrishnan
{"title":"SREDA: An Uncommon and Misleading EEG Rhythm.","authors":"Sheba Anna Shaji, Aparna E G, Biji Bahuleyan, Fathima Noushad, Sanu J Vincent, Aswathy Suresh, Ashalatha Radhakrishnan","doi":"10.1080/21646821.2023.2249773","DOIUrl":"10.1080/21646821.2023.2249773","url":null,"abstract":"<p><p>Subclinical Rhythmic Electroencephalographic Discharges of Adults (SREDA) is a benign EEG variant characterized by sharply contoured rhythmic theta activity occurring bilaterally with maximum activity over the parietal or the posterior head region. These paroxysms are not associated with any objective or subjective clinical manifestations. SREDA, the rarest and last reported benign EEG pattern with no known clinical significance yet, is detailed in this case report. We provide the case of a gentleman with epilepsy who underwent vEEG recording in our lab. The described case is interesting due to its EEG characteristics as well as its clinical picture, which misled us for at least a while. It provides an illustration of how over interpretation of normal EEG patterns may result in an incorrect diagnosis.</p>","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":" ","pages":"245-251"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41213653","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}
Jaime R López, Linda Kelly, Judy Ahn-Ewing, Ron Emerson, Carrie Ford, Clare Gale, Jeffery H Gertsch, Aatif Husain, John Kincaid, Meledy Kise, Adam Kornegay, Joseph J Moreira, Marc Nuwer, Anita Schneider, Lucy R Sullivan, J Richard Toleikis, Lois Wall, Susan Herman
{"title":"<b>Response to a Letter to the Editor by Gregory et al. Regarding:</b> \"Guidelines for Qualifications of Neurodiagnostic Personnel: A Joint Position Statement of the American Clinical Neurophysiology Society, the American Association of Neuromuscular & Electrodiagnostic Medicine, the American Society of Neurophysiological Monitoring, and ASET - The Neurodiagnostic Society\".","authors":"Jaime R López, Linda Kelly, Judy Ahn-Ewing, Ron Emerson, Carrie Ford, Clare Gale, Jeffery H Gertsch, Aatif Husain, John Kincaid, Meledy Kise, Adam Kornegay, Joseph J Moreira, Marc Nuwer, Anita Schneider, Lucy R Sullivan, J Richard Toleikis, Lois Wall, Susan Herman","doi":"10.1080/21646821.2023.2271362","DOIUrl":"https://doi.org/10.1080/21646821.2023.2271362","url":null,"abstract":"","PeriodicalId":22816,"journal":{"name":"The Neurodiagnostic Journal","volume":"63 4","pages":"296-300"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811061","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}