Muhammad Rehman , Chris Gyan , Chinar Osman , Ramamurthy Arunachalam
{"title":"Beyond the triad: Review of Miller Fisher Syndrome in a tertiary neurological centre","authors":"Muhammad Rehman , Chris Gyan , Chinar Osman , Ramamurthy Arunachalam","doi":"10.1016/j.cnp.2025.06.006","DOIUrl":"10.1016/j.cnp.2025.06.006","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 234-235"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548596","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}
Essi J. Marttinen Rossi , Päivi Nevalainen , Jussi Toppila , Helena Mäenpää , Jessica Guzmán-López , Harri Piitulainen , Leena Lauronen
{"title":"Spinal excitability is enhanced by transcranial magnetic stimulation of the motor cortex in children and adolescents","authors":"Essi J. Marttinen Rossi , Päivi Nevalainen , Jussi Toppila , Helena Mäenpää , Jessica Guzmán-López , Harri Piitulainen , Leena Lauronen","doi":"10.1016/j.cnp.2025.06.009","DOIUrl":"10.1016/j.cnp.2025.06.009","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the modulation of spinal excitability to sub-motor threshold transcranial magnetic stimulation (TMS) in healthy children and adolescents.</div></div><div><h3>Methods</h3><div>We paired sub-motor threshold TMS (conditioning) with electrical tibial nerve stimulation (test) to assess changes in the soleus H-reflex at eleven conditioning-test (C-T) intervals. Eleven participants (7.5–16.2 years) were studied under three conditions: rest, voluntary agonist activation (ankle plantar flexion), and voluntary antagonist activation (ankle dorsiflexion).</div></div><div><h3>Results</h3><div>TMS-induced supraspinal volley facilitated the soleus H-reflex amplitude significantly during rest and agonist activation, but not during antagonist activation. The facilitation of H-reflex was similar during rest and agonist activation between C-T intervals from –2 ms (i.e. peripheral stimulation before cortical) to +18 ms (i.e. cortical stimulation before peripheral). Specific to rest condition, a later facilitation occurred at C-T intervals of approximately +60 ms.</div></div><div><h3>Conclusions</h3><div>Spinal excitability modulation in children and adolescents showed similarities to earlier evidence in adults, with the distinction that, unlike in the adults, agonist activity did not further enhance the supraspinal facilitation of the H-reflex compared to the rest condition in children.</div></div><div><h3>Significance</h3><div>These results provide insight into the maturation of motor control and regulation of spinal excitability, offering possibilities to identify typical and atypical developmental trajectories.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 278-285"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632001","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 underlying mechanism of mirror visual feedback in stroke. In reply to: challenging the electrophysiological interpretation of mirror visual feedback in stroke","authors":"Jinyang Zhuang","doi":"10.1016/j.cnp.2025.08.007","DOIUrl":"10.1016/j.cnp.2025.08.007","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 402-403"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104577","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}
Karolina af Edholm , Mikkel C. Vinding , Christoph Pfeiffer , Anders Svenningsson , Erik Fransén , Mathias Sundgren , Henrik Sjöström , Niklas Edvall , Daniel Lundqvist , Josefine Waldthaler
{"title":"Cortical response to proprioceptive stimulation in primary orthostatic tremor – a magnetoencephalography study","authors":"Karolina af Edholm , Mikkel C. Vinding , Christoph Pfeiffer , Anders Svenningsson , Erik Fransén , Mathias Sundgren , Henrik Sjöström , Niklas Edvall , Daniel Lundqvist , Josefine Waldthaler","doi":"10.1016/j.cnp.2025.04.002","DOIUrl":"10.1016/j.cnp.2025.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>Patients with primary orthostatic tremor (OT) are affected by a strong feeling of instability. Our aim was to investigate whether cortical response to proprioceptive information is altered in OT compared with healthy control subjects (HC) using magnetoencephalography (MEG).</div></div><div><h3>Methods</h3><div>Fifteen OT patients and 15 HCs were examined using whole-head MEG. Proprioceptive stimulation was evoked by passive movements of the right index finger and right foot. Time-frequency responses were extracted in the frequency range of 8–30 Hz. The MEG sensor with the highest amplitude change time-locked to the proprioceptive stimulus was used to calculate the amplitude of event-related desynchronization (ERD) and subsequent event-related re-synchronization (ERS).</div></div><div><h3>Results</h3><div>Finger stimulation induced reliable ERD and ERS, as expected, in both OT patients and HC. Foot stimulation induced weaker ERS in both groups. Cluster-based permutation tests did not reveal any significant differences between the OT and HC groups.</div></div><div><h3>Discussion</h3><div>We did not find evidence supporting a generally altered cortical response to proprioceptive stimulation in patients with OT.</div></div><div><h3>Significance</h3><div>This is the first study on proprioceptive cortical processing in OT. The results do not support the interpretation that the characteristic intense feeling of instability in OT is linked to altered cortical response to proprioceptive information.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 159-166"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143923885","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":"A new method to evaluate staircase phenomenon in skeletal muscle using piezoelectric sensor","authors":"Bungo Hirose , Tomihiro Imai , Kazuna Ikeda , Emiko Tsuda , Rika Yamauchi , Tatsuya Abe , Shin Hisahara","doi":"10.1016/j.cnp.2024.12.002","DOIUrl":"10.1016/j.cnp.2024.12.002","url":null,"abstract":"<div><h3>Objective</h3><div>The staircase phenomenon, which refers to the increases in the force of contraction with repetitive stimulation of the muscle, has been studied for many years, but the method is difficult and not widely used. Our objective was to evaluate the staircase phenomenon in skeletal muscle using a piezoelectric sensor.</div></div><div><h3>Methods</h3><div>Thirty-five subjects without neuromuscular diseases (normal controls), 11 patients with Becker muscular dystrophy (BMD), and 19 patients with myotonic dystrophy type 1 (MyD) were studied. Compound muscle action potential (CMAP) and movement-related potential (MRP) waveforms were recorded using piezoelectric sensors during repetitive stimulation of the median nerve, and the amplitudes and durations were measured. Excitation-contraction (E-C) coupling time (ECCT) was calculated from the difference between onset latencies of CMAP and MRP.</div></div><div><h3>Results</h3><div>In normal controls, MRP amplitude ratio (relative to baseline) increased significantly with increase in stimulation duration and with increase in stimulation frequency. In BMD and MyD, however, MRP amplitude ratio did not change significantly with increase in stimulation duration. Especially, in MyD, there was no change in MRP amplitude ratio with increase in frequency.</div></div><div><h3>Conclusion</h3><div>Staircase phenomenon abnormalities can be evaluated easily using piezoelectric sensors, indicating their potential utility for evaluating E-C coupling impairment in myopathies.</div></div><div><h3>Significance</h3><div>Piezoelectric sensors may be a useful tool to evaluate staircase phenomenon in skeletal muscle.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 1-9"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013341","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":"Competence of healthcare professionals performing electroencephalography test: A systematic review","authors":"Elina Linnavuori , Irina Virtanen , Minna Stolt","doi":"10.1016/j.cnp.2025.03.001","DOIUrl":"10.1016/j.cnp.2025.03.001","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the EEG competence of healthcare professionals and how this competence has been measured in previous literature.</div></div><div><h3>Methods</h3><div>A systematic review following the preferred Reporting Items for Systematic Reviews and Meta-Analyses. A literature search was conducted in CINAHL, PubMed, Scopus, and Web of Science databases focusing on studies that empirically examined the EEG competence of healthcare professionals.</div></div><div><h3>Results</h3><div>A total of 28 studies were included. EEG competence consists of two main categories: knowledge and skills of EEG, and attitudes and values towards EEG. The EEG competence of healthcare professionals was assessed in three different settings: tests, simulations, and real life. The data collection methods were knowledge tests, self-assessments, and observations. The tools were developed by a researcher(s) for the single study and were not psychometrically tested.</div></div><div><h3>Conclusion</h3><div>EEG competence is a multidimensional concept that includes knowledge, skills, attitudes, and values that need to be considered when defining EEG competence and developing tools to measure it.</div></div><div><h3>Significance</h3><div>This systematic review provides information to the educators of healthcare professionals and healthcare organizations involved in developing comprehensive EEG training programs and assessments to foster professional development and ensure reliable diagnostic test results for patients.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 104-115"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619968","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}
Fridha V. Villalpando-Vargas , Fabrizio A. Mortola , Juan C. Barrera de León , Tania P. Sánchez-Murguía , Ilse M. Mora-Rodríguez , Jonathan A. Cisneros-Orozco , Andrea Enríquez-Zaragoza , Karla López-Jiménez , Alioth Guerrero-Aranda
{"title":"Two-year experience of a newly established epilepsy monitoring unit in a resource-limited setting","authors":"Fridha V. Villalpando-Vargas , Fabrizio A. Mortola , Juan C. Barrera de León , Tania P. Sánchez-Murguía , Ilse M. Mora-Rodríguez , Jonathan A. Cisneros-Orozco , Andrea Enríquez-Zaragoza , Karla López-Jiménez , Alioth Guerrero-Aranda","doi":"10.1016/j.cnp.2025.02.012","DOIUrl":"10.1016/j.cnp.2025.02.012","url":null,"abstract":"<div><h3>Objective</h3><div>Epilepsy Monitoring Units (EMUs) play a critical role in epilepsy management, yet they remain scarce in resource-limited settings. This study presents a 2-year experience of a newly implemented EMU in Mexico, evaluating its clinical impact, procedural metrics, and challenges. <em>Methods</em><strong>:</strong> This retrospective study included 117 patients admitted to the EMU of a private hospital in central-western Mexico between February 2023 and December 2024. Patients underwent tailored protocols for long-term video-EEG monitoring for diagnostic clarification, treatment optimization, or presurgical evaluation. Diagnostic and therapeutic outcomes, seizure yield, and safety metrics were described. <em>Results</em><strong>:</strong> The EMU facilitated diagnostic changes in 59% of patients, with 80.3% undergoing treatment modifications. Among presurgical evaluation patients, 80.8% exhibited seizures during admission. Seventy-two percent of patients achieved a favorable seizure outcome at one-year follow-up. Twelve patients underwent epilepsy surgery, with resective procedures being the most common. Status epilepticus and seizure clusters, occurred in 2.5% and 0.8% of patients, respectively. <em>Conclusion</em><strong>:</strong> The implementation of a high-quality EMU is achievable in resource-limited settings. <em>Significance</em>: This study highlights the importance of tailored protocols and multidisciplinary collaboration, providing a practical framework enhancing epilepsy care and bridging gaps in epilepsy management in underserved regions.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 84-89"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594095","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}
Bayron A. Sandoval-Bonilla , Isela Valverde Luna , Aleida Arritola-Uriarte , Daniel San-Juan , Ricardo García-Iturbide , Alma Edith Gress Mendoza , Lorely Cumplido Pulido , Lizzette Hinojosa González , Alfredo Lara Bahena , Maria F. De la Cerda Vargas
{"title":"Intraoperative monitoring during awake craniotomy for glioblastoma resection in the second trimester of pregnancy. A case report and literature review","authors":"Bayron A. Sandoval-Bonilla , Isela Valverde Luna , Aleida Arritola-Uriarte , Daniel San-Juan , Ricardo García-Iturbide , Alma Edith Gress Mendoza , Lorely Cumplido Pulido , Lizzette Hinojosa González , Alfredo Lara Bahena , Maria F. De la Cerda Vargas","doi":"10.1016/j.cnp.2025.02.006","DOIUrl":"10.1016/j.cnp.2025.02.006","url":null,"abstract":"<div><h3>Objective</h3><div>To demonstrate the feasibility and safety of awake craniotomy (AC) with intraoperative neurophysiological monitoring (IONM) for glioblastoma (GB) resection in a pregnant patient, ensuring preservation of neurological functions and fetal well-being.</div></div><div><h3>Methods</h3><div>A 27-year-old gravida 2, para 1 woman presented at 19.4 weeks of pregnancy with severe headaches and a generalized tonic-clonic seizure. Imaging confirmed a malignant glioma, and an interdisciplinary team opted for AC with IONM to achieve maximal tumor resection while minimizing maternal and fetal risks.</div></div><div><h3>Results</h3><div>Surgery was performed during the second trimester with successful gross total resection of the tumor. IONM strategies preserved neurological function, and fetal well-being was maintained. Postoperative evaluations showed no complications, and the patient was discharged in improved condition.</div></div><div><h3>Conclusions</h3><div>AC with IONM is a viable and safe surgical approach for GB resection during pregnancy. Tailoring the surgical plan by considering gestational age, maternal health, and fetal safety is crucial.</div></div><div><h3>Significance</h3><div>This case highlights the importance of multidisciplinary management in optimizing outcomes for pregnant patients with GB, contributing valuable insights to the limited literature on neurosurgical interventions during pregnancy.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 63-69"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580354","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}
Asbjoern W. Helge , Federico G. Arguissain , Lukas Lechner , Gerhard Gritsch , Jonas Duun-Henriksen , Esben Ahrens , Tilmann Kluge , Manfred Hartmann
{"title":"Longitudinal, EEG-based assessment of sleep in people with epilepsy: An automated sleep staging algorithm non-inferior to human raters","authors":"Asbjoern W. Helge , Federico G. Arguissain , Lukas Lechner , Gerhard Gritsch , Jonas Duun-Henriksen , Esben Ahrens , Tilmann Kluge , Manfred Hartmann","doi":"10.1016/j.cnp.2025.01.001","DOIUrl":"10.1016/j.cnp.2025.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>There is an unmet need in epilepsy management for tools that measure sleep objectively over long timespans. Subcutaneous EEG is well-suited for the task, but it requires a reliable automatic algorithm. Here, we present and evaluate such an algorithm, and we show clinical examples of how it produces important information.</div></div><div><h3>Methods</h3><div>A mix of scalp EEG and subcutaneous EEG was used to develop an algorithm to output sleep stages and common sleep parameters. The algorithm was tested on unseen data from 11 healthy subject and 12 people with epilepsy (PwE). Lastly, data (>3months) from three exemplary PwE were analyzed for sleep.</div></div><div><h3>Results</h3><div>The algorithm proved non-inferior at sleep stage segmentation on data from PwE compared to human raters using scalp EEG. It reached a Cohen’s kappa score of 0.8 [CI 0.78 – 0.83] on healthy subjects and on data from PwE it got to 0.705 [CI 0.663–––0.744] against rater D and 0.686 [CI 0.632–––0.739] against rater E. The three examples showed that useful information can be gained from longitudinal sleep analysis.</div></div><div><h3>Conclusion</h3><div>Subcutaneous EEG and a sleep algorithm can be employed to effectively review sleep in PwE at a level that is non-inferior compared to human raters.</div></div><div><h3>Significance</h3><div>This has the potential to make objective sleep parameters available in the clinic as a valuable addition to subjective sleep assessments.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 30-39"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175361","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}
Laurent Sheybani , Pia De Stefano , Margitta Seeck , Serge Vulliémoz , Pierre Mégevand
{"title":"EEG focal delta slowing in focal epilepsy – A didactic review","authors":"Laurent Sheybani , Pia De Stefano , Margitta Seeck , Serge Vulliémoz , Pierre Mégevand","doi":"10.1016/j.cnp.2025.09.001","DOIUrl":"10.1016/j.cnp.2025.09.001","url":null,"abstract":"<div><div>Focal slowing in scalp electroencephalography (EEG) is classically seen as an unspecific entity in terms of its association with both epilepsy and distinct aetiologies. This could be due to a lack of standardization in the assessment of slowing morphology, in distinction to precise guidelines utilized in the evaluation of pathological activities, such as interictal epileptiform discharges (IEDs). However, consistent features can be identified, which can be informative about the underlying brain pathology and risk of seizures. In this review, we discuss the different kinds of focal slowing, focusing mainly on the delta range (0.5–4 Hz), their respective pathological processes and their prognostic value in terms of likelihood to be associated with acute seizures or epilepsy. We then present new findings on source localization of focal slowing. Last, we review recent evidence of interaction between focal slow activities and epileptic activities. Our didactic approach will guide readers through important aspects of an EEG entity that might have been neglected despite past and recent observations of its relevance in epilepsy.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 392-401"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104576","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}