Clinical Neurophysiology Practice最新文献_第10页

Impact of ambulatory EEG in the management of patients with epilepsy in resource-limited Latin American populations 在资源有限的拉丁美洲人群中，动态脑电图对癫痫患者管理的影响

IF 1.7

Clinical Neurophysiology Practice Pub Date : 2023-01-01 DOI: 10.1016/j.cnp.2023.10.001

Alioth Guerrero-Aranda , Francisco J. Taveras-Almonte , Fridha V. Villalpando-Vargas , Karla López-Jiménez , Gloria M. Sandoval-Sánchez , Julio Montes-Brown

{"title":"Impact of ambulatory EEG in the management of patients with epilepsy in resource-limited Latin American populations","authors":"Alioth Guerrero-Aranda , Francisco J. Taveras-Almonte , Fridha V. Villalpando-Vargas , Karla López-Jiménez , Gloria M. Sandoval-Sánchez , Julio Montes-Brown","doi":"10.1016/j.cnp.2023.10.001","DOIUrl":"https://doi.org/10.1016/j.cnp.2023.10.001","url":null,"abstract":"<div><h3>Objective</h3><p>Ambulatory electroencephalography (AEEG) monitoring allows for prolonged recordings in normal environments, such as patients’ homes, and is recognized as a cost-effective alternative to inpatient long-term video-EEG primarily in resource-limited countries. We aim to describe the impact of AEEG on the assessment of patients with suspected or confirmed epilepsy in two independent Latin-American populations with limited resources.</p></div><div><h3>Methods</h3><p>We included 63 patients who had undergone an AEEG due to confirmed/suspected epilepsy. Clinical (demographic, current antiseizure medication and indication) and electroencephalographic (duration of the study, result, and impact on clinical decision-making) were reviewed and compared.</p></div><div><h3>Results</h3><p>The main indication for an AEEG was the differentiation of seizures from non-epileptic events with 57% of patients. It was categorized as positive in 36 patients and did have an impact on the clinical decision-making process in 57% of patients. AEEG captured clinical events in 35 patients (20 epileptic and 15 non-epileptic).</p></div><div><h3>Conclusions</h3><p>AEEG proves to be a valuable tool in resource-limited settings for assessing suspected or confirmed epilepsy cases, with a significant impact on clinical decisions.</p></div><div><h3>Significance</h3><p>Our study provides valuable insights into the use of AEEG in under-resourced regions, shedding light on the challenges and potential benefits of this tool in clinical practice.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 197-202"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X23000264/pdfft?md5=f71c3bbc06eab1ace763ecb46720c569&pid=1-s2.0-S2467981X23000264-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134656000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The future is data-driven: A call to clinical neurophysiology laboratories to standardize your NCS data 未来是数据驱动的:呼叫临床神经生理学实验室标准化你的NCS数据

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Clinical Neurophysiology Practice Pub Date : 2023-01-01 DOI: 10.1016/j.cnp.2023.05.002

Øystein Dunker, Marie U. Lie, Aristomo Andries, Kristian Bernhard Nilsen, Petter Omland, Andrew Reiner, Martijn R. Tannemaat, Robert H. Reijntjes, Joe F. Jabre

引用次数: 0

Lance-Adams Syndrome: Case series and literature review Lance-Adams综合征：病例系列和文献综述。

IF 1.7

Clinical Neurophysiology Practice Pub Date : 2023-01-01 DOI: 10.1016/j.cnp.2023.08.002

Judy Zheng , Zachary Storad , Mustafa Al-Chalabi , Khaled Gharaibeh , Sidra Saleem , Ajaz Sheikh , Naeem Mahfooz

{"title":"Lance-Adams Syndrome: Case series and literature review","authors":"Judy Zheng , Zachary Storad , Mustafa Al-Chalabi , Khaled Gharaibeh , Sidra Saleem , Ajaz Sheikh , Naeem Mahfooz","doi":"10.1016/j.cnp.2023.08.002","DOIUrl":"10.1016/j.cnp.2023.08.002","url":null,"abstract":"<div><h3>Background</h3><p>Lance-Adams Syndrome (LAS) is a rare complication of successful cardiopulmonary resuscitation (CPR). It is a form of posthypoxic myoclonus characterized by action or intention myoclonus developing days to months after an hypoxic insult to the brain. LAS, especially early in a patient’s clinical course, can be challenging to diagnose. Electroencephalogram (EEG) pattern of midline spike-wave discharge associated with favorable prognosis. There is no consensus in treatment of LAS but use of various anti-epileptic medications has been documented in literature.</p></div><div><h3>Case Presentation</h3><p>In this case series, all of the patients presented after achieving return of spontaneous circulation (ROSC) and subsequently developed myoclonus. EEG findings beyond the initial hospitalization continued to show later showed changes consistent with LAS in three of the four patients. Different combinations of AEDs were used in the management of LAS with variable success and adverse effects.</p></div><div><h3>Conclusion</h3><p>Our cases highlight that the characteristic EEG pattern can be useful in the diagnosis of LAS and allow for better prognostication and management in patients with posthypoxic myoclonus. We reviewed the available literature to better understand the prevalence, mechanism, clinical presentation, diagnosis, and management of LAS.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 187-193"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/60/cc/main.PMC10562981.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nerve ultrasonographic findings in diabetes mellitus are determined by anatomical location and type of diabetes 糖尿病的神经超声表现取决于解剖位置和糖尿病的类型

IF 1.7

Clinical Neurophysiology Practice Pub Date : 2023-01-01 DOI: 10.1016/j.cnp.2023.04.004

Marianna Tóth , Annamária Szőke , Zsuzsanna Arányi

{"title":"Nerve ultrasonographic findings in diabetes mellitus are determined by anatomical location and type of diabetes","authors":"Marianna Tóth , Annamária Szőke , Zsuzsanna Arányi","doi":"10.1016/j.cnp.2023.04.004","DOIUrl":"10.1016/j.cnp.2023.04.004","url":null,"abstract":"<div><h3>Objective</h3><p>A prospective ultrasound study to analyze nerve size and its modifying factors in type 1 and type 2 diabetes mellitus.</p></div><div><h3>Methods</h3><p>The cross-sectional areas (CSAs) of motor and sensory nerves in both upper and lower limbs were measured at 14 measurement points, using high resolution ultrasound in 26 patients with type 1 and 76 patients with type 2 diabetes, and in 50 control subjects. All diabetic patients underwent electrophysiological assessment to check for the presence of polyneuropathy.</p></div><div><h3>Results</h3><p>Significant mild/moderate diffuse nerve enlargement was demonstrated in type 2 diabetes, more pronounced at compression sites versus non-compression sites, and on the upper limbs versus lower limbs (p value for pooled DM2 v. control group: <0.001). In type 1 diabetes, nerve enlargement was found only at one compression site (median nerve wrist; p = 0.002). No significant difference was found between patients with or without polyneuropathy.</p></div><div><h3>Conclusions</h3><p>The primary predictors of nerve size in diabetes are anatomical location (i.e. compression sites versus non-compression sites, upper versus lower limbs) and type of diabetes. Changes occur before the electrophysiological signs of polyneuropathy are detected.</p></div><div><h3>Significance</h3><p>Nerve ultrasound may contribute to early recognition of the neuropathic complications of diabetes.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"8 ","pages":"Pages 115-122"},"PeriodicalIF":1.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42529013","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}

引用次数: 1

Amplitude-reduction alert criteria and intervention during complex paediatric cervical spine surgery 复杂小儿颈椎手术中振幅降低预警标准和干预措施

IF 1.7

Clinical Neurophysiology Practice Pub Date : 2022-01-01 DOI: 10.1016/j.cnp.2022.07.003

William M. McDevitt , Laura Quinn , W.S.B. Wimalachandra , Edmund Carver , Catalina Stendall , Guirish A. Solanki , Andrew Lawley

{"title":"Amplitude-reduction alert criteria and intervention during complex paediatric cervical spine surgery","authors":"William M. McDevitt , Laura Quinn , W.S.B. Wimalachandra , Edmund Carver , Catalina Stendall , Guirish A. Solanki , Andrew Lawley","doi":"10.1016/j.cnp.2022.07.003","DOIUrl":"10.1016/j.cnp.2022.07.003","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the utility of widely used intraoperative neuromonitoring (IONM) alert criteria and intervention for predicting postoperative outcome following paediatric spinal surgery.</p></div><div><h3>Methods</h3><p>Retrospective analysis of somatosensory evoked potentials (SSEP) and motor evoked potentials (MEP) in consecutive cervical spine fixations. An intervention protocol followed amplitude-reductions in SSEPs (≥50 %) and/or MEPs (≥80 %). Alert breaches were reversed when SSEP/MEP amplitude was restored to > 50 %/20 % of baseline. Sensorimotor function was assessed preoperatively and 3-months postoperatively via the Modified McCormick Scale score (MMS). We explored associations between postoperative outcome, demographic/surgical and IONM variables.</p></div><div><h3>Results</h3><p>Forty-five procedures in 38 children (mean age:9 ± 4 years;55 % female) were monitored, 42 %of which breached alert criteria. Instrumentation (6/19,32 %) and hypotension (5/19,26 %) were common causes for alert and the majority (13/19,68 %) were reversed following intervention. There was an association between pre- and post-MMS and the type of breach (p = 0.002). All children with worse postoperative MMS (3/38,8%) had irreversible breaches.</p></div><div><h3>Conclusions</h3><p>IONM in this small sample accurately detected neurological injury. The majority of breaches reversed following an intervention protocol. Irreversible breaches frequently led to worse postoperative sensorimotor function.</p></div><div><h3>Significance</h3><p>An intervention protocol which reversed IONM alerts never resulted in postoperative worsening of sensorimotor function.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 239-244"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9420322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40333339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Utility of evoked potentials during anterior cerebral artery and anterior communicating artery aneurysm clipping 大脑前动脉和前交通动脉瘤夹闭过程中诱发电位的应用

IF 1.7

Clinical Neurophysiology Practice Pub Date : 2022-01-01 DOI: 10.1016/j.cnp.2022.07.001

Ferenc Rabai , Claire M. Dorey , W. Christopher Fox , Krista M. Fitzgerald , Christoph N. Seubert , Steven A. Robicsek

{"title":"Utility of evoked potentials during anterior cerebral artery and anterior communicating artery aneurysm clipping","authors":"Ferenc Rabai , Claire M. Dorey , W. Christopher Fox , Krista M. Fitzgerald , Christoph N. Seubert , Steven A. Robicsek","doi":"10.1016/j.cnp.2022.07.001","DOIUrl":"10.1016/j.cnp.2022.07.001","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the optimal combination of somatosensory- and transcranial motor-evoked potential (SSEP/tcMEP) modalities and monitored extremities during clip reconstruction of aneurysms of the anterior cerebral artery (ACA) and its branches.</p></div><div><h3>Methods</h3><p>A retrospective review of 104 cases of surgical clipping of ruptured and unruptured aneurysms was performed. SSEP/tcMEP changes and postoperative motor deficits (PMDs) were assessed from upper and lower extremities (UE/LE) to determine the diagnostic accuracy of each modality separately and in combination.</p></div><div><h3>Results</h3><p>PMDs were reported in 9 of 104 patients; 7 LE and 8 UE (3.6% of 415 extremities). Evoked potential (EP) monitoring failed to predict a PMD in 8 extremities (1.9%). Seven of 8 false negatives had subarachnoid hemorrhage. Sensitivity and specificity in LE were 50% and 97% for tcMEP, 71% and 98% for SSEP, and 83% and 98% for dual-monitoring of both tcMEP/SSEP. Sensitivity and specificity in UE were 38% and 99% for tcMEP, and 50% and 97% for tcMEP/SSEP, respectively.</p></div><div><h3>Conclusions</h3><p>Combined tcMEP/SSEP is more accurate than single-modality monitoring for LE but is relatively insensitive for UE PMDs.</p></div><div><h3>Significance</h3><p>During ACA aneurysm clipping, multiple factors may confound the ability of EP monitoring to predict PMDs, especially brachiofacial hemiparesis caused by perforator insufficiency.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 228-238"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/64/main.PMC9352509.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40676599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Emerging role of clinical neurophysiology in the diagnosis of movement disorders 临床神经生理学在运动障碍诊断中的新作用

IF 1.7

Clinical Neurophysiology Practice Pub Date : 2022-01-01 DOI: 10.1016/j.cnp.2022.01.003

Shabbir Hussain I. Merchant

引用次数: 0

A test to determine the site of abnormal neuromuscular refractoriness 一种确定异常神经肌肉难治性部位的试验

IF 1.7

Clinical Neurophysiology Practice Pub Date : 2022-01-01 DOI: 10.1016/j.cnp.2021.11.001

Hatice Tankisi , Hugh Bostock , Peter Grafe

{"title":"A test to determine the site of abnormal neuromuscular refractoriness","authors":"Hatice Tankisi , Hugh Bostock , Peter Grafe","doi":"10.1016/j.cnp.2021.11.001","DOIUrl":"10.1016/j.cnp.2021.11.001","url":null,"abstract":"<div><h3>Objective</h3><p>The relative refractory period (RRP) of motor axons is an important parameter in nerve excitability tests of the recovery cycle (RC). Abnormalities may have a site in the axonal membrane, the neuromuscular junction, or in a dysfunction of the muscle. We aimed in this study to determine the site of abnormality, using a modified protocol of the conventional RC test, whereby an additional supramaximal stimulus is added at the same interstimulus interval as in RC recordings (RCSM).</p></div><div><h3>Methods</h3><p>Twenty-four healthy subjects aged 37.8 ± 2.4 years (mean ± SE) were examined with median nerve excitability testing using RC and RCSM protocols at normal temperature (34.1 ± 0.2 °C). The recordings were repeated in 12 subjects after selective cooling of the thenar muscle (25.2 ± 0.7 °C) and in 12 subjects after cooling the nerve trunk at the wrist (24.9 ± 0.3 °C).</p></div><div><h3>Results</h3><p>After cooling the nerve, RRP measured with RC and RCSM were prolonged similarly (medians by 1.8 ms, and 2.1 ms respectively). In contrast, cooling the muscle prolonged RRP measured with RC (by 1.3 ms), but did not significantly prolong RRP measured with RCSM. RRPs measured by RC and RCSM were significantly different when cooling was at the muscle (P = 5.10<sup>-4</sup>), but not when cooling was at the nerve (P = 0.57).</p></div><div><h3>Conclusions</h3><p>A difference between RC and RCSM indicates abnormal excitability distal to the axonal membrane under the stimulating electrode.</p></div><div><h3>Significance</h3><p>Combining RCSM with the conventional RC protocol should help to localize the site of abnormal neuromuscular refractoriness.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 1-6"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/07/e9/main.PMC8693356.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39785390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The split-elbow index: A biomarker of the split elbow sign in ALS 劈裂肘指数:ALS中劈裂肘征的生物标志物

IF 1.7

Clinical Neurophysiology Practice Pub Date : 2022-01-01 DOI: 10.1016/j.cnp.2021.11.002

Nathan Pavey , Mana Higashihara , Mehdi A.J. van den Bos , Parvathi Menon , Steve Vucic

{"title":"The split-elbow index: A biomarker of the split elbow sign in ALS","authors":"Nathan Pavey , Mana Higashihara , Mehdi A.J. van den Bos , Parvathi Menon , Steve Vucic","doi":"10.1016/j.cnp.2021.11.002","DOIUrl":"10.1016/j.cnp.2021.11.002","url":null,"abstract":"<div><h3>Objective</h3><p>The split elbow sign is a clinical feature of amyotrophic lateral sclerosis (ALS), characterised by preferential weakness of biceps brachii muscle compared to triceps. A novel neurophysiological index, termed the <em>split elbow index (SEI)</em>, was developed to quantify the split-elbow sign, and assess its utility in ALS.</p></div><div><h3>Methods</h3><p>Clinical and neurophysiological assessment was prospectively undertaken on 34 ALS patients and 32 ALS mimics. Compound muscle action potential (CMAP) amplitude was recorded from biceps brachii and triceps muscles from which the SEI was calculated using the following formula:</p><p><span><math><mrow><mi>SEI</mi><mo>=</mo><mfrac><mrow><mi>CMAPamplitudeBICEPSBRACHII</mi></mrow><mrow><mi>CMAPamplitudeTRICEPSBRACHII</mi></mrow></mfrac></mrow></math></span></p></div><div><h3>Results</h3><p>The split elbow sign was significantly more common in ALS patients when compared to ALS mimic patients (P < 0.05). The SEI was significantly reduced in ALS patients when compared to ALS mimics (P < 0.01). This reduction was evident in spinal and bulbar onset ALS. A SEI cut-off value of ≤0.62 exhibited a sensitivity of 71% and specificity of 61%.</p></div><div><h3>Conclusions</h3><p>The split elbow sign is significantly more common in ALS patients, and was supported by a reduction in the SEI.</p></div><div><h3>Significance</h3><p>The SEI may be utilised as a surrogate biomarker of the split elbow sign in future ALS studies.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 16-20"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/5a/main.PMC8733259.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39816986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Spinal reflexes and brain death 脊髓反射与脑死亡

IF 1.7

Clinical Neurophysiology Practice Pub Date : 2022-01-01 DOI: 10.1016/j.cnp.2022.05.001

Michael Nair-Collins

引用次数: 0