Clinical Neurophysiology Practice最新文献

{"title":"Bringing nerve excitability out of the research laboratory into the clinic","authors":"Karl Ng","doi":"10.1016/j.cnp.2022.10.001","DOIUrl":"10.1016/j.cnp.2022.10.001","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 317-318"},"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/8c/08/main.PMC9636407.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40671142","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}

{"title":"The utility of intraoperative neurophysiological monitoring in surgical treatment for spinal arteriovenous malformations: A historical control study","authors":"Sooyoung Kim ,&nbsp;Haelim Kim ,&nbsp;Jun-Soon Kim ,&nbsp;Seung-Jae Hyun ,&nbsp;Ki-Jeong Kim ,&nbsp;Kyung Seok Park","doi":"10.1016/j.cnp.2022.01.004","DOIUrl":"10.1016/j.cnp.2022.01.004","url":null,"abstract":"<div><h3>Objective</h3><p>This study sought to investigate the utility of intraoperative neurophysiological monitoring (IONM) in the surgical treatment for spinal arteriovenous malformations (SAVMs).</p></div><div><h3>Methods</h3><p>We retrospectively reviewed the data of 39 patients who underwent surgical treatment for SAVMs. Twenty-eight patients who received multimodal IONM (transcranial electrical motor-evoked potentials [MEPs], somatosensory-evoked potentials, continuous electromyography, and bulbocavernosus reflex [BCR]) between 2011 and 2020 were compared to 11 historical controls between 2003 and 2011. The rates of postoperative neurological deficits (PNDs), neurophysiological warnings, and their characteristics were analyzed.</p></div><div><h3>Results</h3><p>PNDs were developed in 10.7% and 54.5% of patients in the IONM and historical control (non-IONM) groups, respectively (<em>p</em> = 0.008). Moreover, not applying IONM was the only significant risk factor for the development of PNDs in the logistic regression analysis (odds ratio 10.0, <em>p</em> = 0.007). In the IONM group, a total of three electrophysiological warnings were observed, and two of these were true positives; one patient complained of leg motor weakness after surgery with loss of the abductor halluces MEPs. The other patient experienced disappearance of the BCR during surgery and newly developed urinary retention. Overall, the sensitivity, specificity, positive predictive value, and negative predictive value of IONM warnings for detecting PNDs were 66.7%, 96.0%, 66.7%, and 96.0%, respectively.</p></div><div><h3>Conclusions</h3><p>The neurological outcome of the IONM group was significantly better than that of the historical control group in the surgical treatments for SAVMs.</p></div><div><h3>Significance</h3><p>Multimodal IONM could be a useful tool to detect neurological damage with relatively high accuracy in this type of surgery.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 59-64"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X22000063/pdfft?md5=6d68f65ccb64135234bd7e60dc76f38e&pid=1-s2.0-S2467981X22000063-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44974577","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}

{"title":"Eye-opening in brain death: A case report and review of the literature","authors":"Martina Focardi ,&nbsp;Barbara Gualco ,&nbsp;Maenia Scarpino ,&nbsp;Manuela Bonizzoli ,&nbsp;Beatrice Defraia ,&nbsp;Riccardo Carrai ,&nbsp;Giovanni Lanzo ,&nbsp;Silvia Raddi ,&nbsp;Ilenia Bianchi ,&nbsp;Antonello Grippo","doi":"10.1016/j.cnp.2022.03.006","DOIUrl":"10.1016/j.cnp.2022.03.006","url":null,"abstract":"<div><h3>Background</h3><p>According to Italian law, brain death is diagnosed when the patient is in a coma, showing the absence of respiratory drive under specific clinical conditions, and without any brain stem reflexes. On the other hand, presence of spinal reflexes, when correctly identified, does not hamper the diagnosis.</p></div><div><h3>Case report</h3><p>We present a case of eyelid elevation two seconds after thoracic pain stimulation in a patient who otherwise fulfilled all clinical and instrumental brain-death criteria due to a residual preserved function of the superior cervical ganglion.</p></div><div><h3>Conclusion</h3><p>Although the observed reflex is to be considered extracerebral, and therefore it should not hamper the diagnosis of BD, the authors propose implementing cerebral flow evaluation, considered “prudential”, as a preliminary assessment before determining BD.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 139-142"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X22000191/pdfft?md5=0c5d0b2a34c43a369e58b0bc15fcbee5&pid=1-s2.0-S2467981X22000191-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48300984","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}

{"title":"Sural-sparing pattern: A study against electrodiagnostic subtypes of Guillain–Barre syndrome","authors":"Nath Pasutharnchat ,&nbsp;Varis Ratanasirisawad ,&nbsp;Manasawan Santananukarn ,&nbsp;Chamaiporn Taychargumpoo ,&nbsp;Jakkrit Amornvit ,&nbsp;Chaipat Chunharas","doi":"10.1016/j.cnp.2022.09.001","DOIUrl":"10.1016/j.cnp.2022.09.001","url":null,"abstract":"<div><h3>Objective</h3><p>To study sural-sparing pattern in Guillain<strong>–</strong>Barre syndrome (GBS) and compare it among GBS’s electrodiagnostic subtypes, classified by two recent criteria.</p></div><div><h3>Methods</h3><p>This study retrospectively reviewed clinical data and electrodiagnostic studies (EDXs) of 88 GBS patients diagnosed in a tertiary care hospital (2010–2019).</p></div><div><h3>Results</h3><p>Overall, 79/88 (89.8%) and 36/45 (80%) patients had bilateral sensory nerve conduction studies (NCS) in the first EDX and follow-up EDX, respectively. Sural-sparing occurred in all subtypes (50% overall occurrence rate), most commonly in demyelination. There was no statistically significant difference in sural-sparing occurrence rates between demyelinating and axonal GBS; however, sural-sparing in axonal GBS tended to show a lower number of abnormal upper-limb sensory nerve action potentials (SNAPs) than demyelinating GBS. Shifting between sural-sparing and no sural-sparing occurred in approximately-one-fourth of patients receiving serial studies. Follow-up EDX additionally discovered 20% of all sural-sparing. Unilateral EDX could have omitted up to 30% of sural-sparing.</p></div><div><h3>Conclusions</h3><p>Sural-sparing is less obviously manifested in axonal than demyelinating GBS, with respect to the number of affected upper-limb SNAPs. Extended sensory NCS is worth in detecting sural-sparing as a supportive electrodiagnostic GBS feature.</p></div><div><h3>Significance</h3><p>This report showed one different character of sural-sparing (number of affected upper-limb SNAPs) between demyelinating and axonal GBS.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 266-272"},"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/7c/70/main.PMC9557237.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33515761","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}

{"title":"Acknowledgement to Reviewers","authors":"","doi":"10.1016/j.cnp.2022.10.003","DOIUrl":"https://doi.org/10.1016/j.cnp.2022.10.003","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 388-389"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2467981X22000415/pdfft?md5=6f695845e988c879ac96f6a7f0d4f759&pid=1-s2.0-S2467981X22000415-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92032439","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}

{"title":"Towards more reliable TMS studies – How fast can we probe cortical excitability?","authors":"Maria Nazarova ,&nbsp;Anastasia Asmolova","doi":"10.1016/j.cnp.2021.11.004","DOIUrl":"10.1016/j.cnp.2021.11.004","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 21-22"},"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/e5/b4/main.PMC8752992.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39940059","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}

{"title":"Tradução e Adaptação para a Língua Portuguesa – Brasil do Glossário Revisado dos Termos Mais Comumente Usados por Eletroencefalografistas Clínicos e Proposta Atualizada do Formato do Laudo de EEG (IFCN Revisão 2017)","authors":"Ana Paula Gonçalves ,&nbsp;Carlos Eduardo Silvado ,&nbsp;Isabella D'Andrea Meira ,&nbsp;José Augusto Bragatti ,&nbsp;Luís Otávio Caboclo ,&nbsp;Mirian Bittar Guaranha ,&nbsp;Priscila Oliveira da Conceição ,&nbsp;Pedro Alessandro Leite de Oliveira ,&nbsp;Taíssa Ferrari Marinho","doi":"10.1016/j.cnp.2021.12.003","DOIUrl":"10.1016/j.cnp.2021.12.003","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 78-95"},"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/a3/0e/main.PMC8933678.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40310675","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}

{"title":"Myoclonus generators in sialidosis","authors":"Felipe Vial ,&nbsp;Patrick McGurrin ,&nbsp;Sanaz Attaripour ,&nbsp;Alesandra d'Azzo ,&nbsp;Cynthia J. Tifft ,&nbsp;Camilo Toro ,&nbsp;Mark Hallett","doi":"10.1016/j.cnp.2022.05.004","DOIUrl":"10.1016/j.cnp.2022.05.004","url":null,"abstract":"<div><h3>Objective</h3><p>Sialidosis is an inborn error of metabolism. There is evidence that the myoclonic movements observed in this disorder have a cortical origin, but this mechanism does not fully explain the bilaterally synchronous myoclonus activity frequently observed in many patients. We present evidence of a subcortical basis for synchronous myoclonic phenomena.</p></div><div><h3>Methods</h3><p>Electromyographic investigations were undertaken in two molecularly and biochemically confirmed patients with sialidosis type-1.</p></div><div><h3>Results</h3><p>The EMG recordings showed clear episodes of bilaterally synchronous myoclonic activity in contralateral homologous muscles. We also observed a high muscular-muscular coherence with near-zero time-lag between these muscles.</p></div><div><h3>Conclusion</h3><p>The absence of coherence phase lag between the right-and-left homologous muscles during synchronous events indicates that a unilateral cortical source cannot fully explain the myoclonic activity. There must exist a subcortical mechanism for bilateral synchronization accounting for this phenomenon.</p></div><div><h3>Significance</h3><p>Understanding this mechanism may illuminate cortical-subcortical relationships in myoclonus.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 169-173"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9253402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40572054","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}

{"title":"The value of intraoperative neurophysiological monitoring during positioning in pediatric scoliosis correction: A case report","authors":"M. Cavinato ,&nbsp;F. Vittoria ,&nbsp;F. Piccione ,&nbsp;S. Masiero ,&nbsp;M. Carbone","doi":"10.1016/j.cnp.2022.11.001","DOIUrl":"10.1016/j.cnp.2022.11.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Prone position during posterior spine surgery can represent a potentially risky procedure for the nervous system. Infrequent injuries due to prone positioning consist of subtle spinal cord infarction or myelopathy that can be promptly detected by intraoperative neurophysiological monitoring (IONM), if applied in this phase of surgery. Here, we report a case that stresses the value of IONM even in detecting spinal positioning-related neurological complications during kyphoscoliosis correction.</p></div><div><h3>Case presentation</h3><p>A 3-year-old child with a severe thoracic kyphoscoliosis with the angle in the tract T5-T6 underwent an early treatment of scoliosis with growing rods. Before instrumentation or the reduction maneuver, lower limb somatosensory and motor responses disappeared. The patient was repositioned with neck and chest in a more protective position and neuromonitoring signals returned to baseline. The surgery could be completed and the patient had no postoperative neurologic or vascular deficits.</p></div><div><h3>Conclusion</h3><p>Our findings suggest the importance of extending neuromonitoring in the early phases of anesthesia induction and patient positioning during corrective spinal deformity surgery.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 366-371"},"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/29/b3/main.PMC9731825.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10680989","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}

{"title":"Neurology resident EEG training in Europe","authors":"Fábio A. Nascimento ,&nbsp;Jay R. Gavvala ,&nbsp;Hatice Tankisi ,&nbsp;Sándor Beniczky","doi":"10.1016/j.cnp.2022.08.001","DOIUrl":"10.1016/j.cnp.2022.08.001","url":null,"abstract":"<div><h3>Objective</h3><p>To detail current European EEG education practices and compare European and U.S. EEG teaching systems.</p></div><div><h3>Methods</h3><p>A 19-question online survey focused on EEG clinical practices and residency training was emailed to all 47 European Academy of Neurology Societies.</p></div><div><h3>Results</h3><p>Thirty-two (68 %) out of the 47 Societies completed the survey. In half of countries, general neurologists are either among the providers or the only providers who typically read EEGs. The number of weeks devoted to EEG learning required to graduate ranged from none to 26, and it was expected to be continuous in one country. In most countries (n = 17/32), trainees read &gt;40 EEGs per EEG rotation, and the most commonly interpreted studies are routine and prolonged routine EEGs. Rotations involve clinic/outpatient (90 %), epilepsy monitoring unit/inpatient (60 %), or both (50 %). Roughly half of countries do not use objective measures to assess EEG competency. The most reported educational methods are teaching during EEG rotation and yearly didactics, and the most reported education barriers are insufficient didactics and insufficient EEG exposure.</p></div><div><h3>Conclusions</h3><p>We suggest neurology educators in Europe, especially in those countries where EEGs are read by general neurologists, consider ensuring that residency EEG learning is mandatory and establishing objective measures in teaching and evaluating competency.</p></div><div><h3>Significance</h3><p>Similar to the U.S., neurology resident EEG training in Europe is highly variable.</p></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"7 ","pages":"Pages 252-259"},"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/26/e8/main.PMC9483746.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33476061","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}