Clinical Neurophysiology Practice最新文献

{"title":"Impaired motor unit profile in Fabry disease: A quantitative electrophysiological study","authors":"Aysegul Gunduz,&nbsp;Aysegul Akkan Suzan,&nbsp;Mevlüt Tamer Dinçer,&nbsp;Şeyda Gül Özcan,&nbsp;Nurhan Seyahi","doi":"10.1016/j.cnp.2026.08.010","DOIUrl":"10.1016/j.cnp.2026.08.010","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the relationship between routine electrophysiological findings, sympathetic function, and the number and size of functioning motor units in Fabry disease.</div></div><div><h3>Methods</h3><div>Thirteen patients with Fabry disease and thirteen healthy individuals were evaluated. Nerve conduction studies and sympathetic skin responses were recorded from upper and lower limbs. Motor unit function was analyzed using the Motor Unit Number Index (MUNIX) technique by recording the first dorsal interosseous (FDI) muscle following ulnar nerve stimulation and the tibialis anterior (TA) muscle following peroneal nerve stimulation.</div></div><div><h3>Results</h3><div>The MUNIX protocol demonstrated excellent reproducibility. MUNIX had excellent reproducibility (coefficient of variation: 20.7% in FDI; 14.7% in TA). FDI-MUNIX and MUSIX values were comparable between groups, whereas TA-CMAP amplitude and MUSIX were significantly lower in patients than in healthy controls, with no significant difference in TA-MUNIX. Correlation analysis revealed a positive association between Lyso-Gb3 and MUNIX-FDI (ρ = 0.55, <em>p</em> = 0.049) and inverse correlations between neuropathy scores and MUSIX-TA (ρ = −0.72, <em>p</em> = 0.013; ρ = −0.76, <em>p</em> = 0.004).</div></div><div><h3>Conclusions</h3><div>The observed reductions in CMAP and MUSIX, particularly in the TA, indicate subtle length-dependent motor unit involvement despite preserved strength and normal MUNIX values.</div></div><div><h3>Significance</h3><div>This study provides the first evidence that MUNIX can detect early or subclinical motor unit alterations in Fabry disease.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 749-756"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945994","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":"Subthalamic beta activity and neuroimaging concordance in deep brain stimulation: electrode placement and clinical outcomes","authors":"Malen Razkin,&nbsp;Edurne Ruiz de Gopegui,&nbsp;Beatriz Tijero,&nbsp;Tamara Fernández del Valle,&nbsp;Gaizka Bilbao,&nbsp;Ainara Dolado,&nbsp;Imanol Lambarri,&nbsp;Juan Carlos Gómez-Estéban,&nbsp;Asier Erramuzpe,&nbsp;Marta Ruiz-Lopez","doi":"10.1016/j.cnp.2026.08.008","DOIUrl":"10.1016/j.cnp.2026.08.008","url":null,"abstract":"<div><h3>Objective</h3><div>Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established therapy for advanced Parkinson's disease (PD), particularly in managing levodopa-induced motor complications and refractory tremor. The STN is the preferred target for high-frequency DBS, where precise electrode placement is key to optimal outcomes. This study assesses the reliability of local field potential (LFP) recordings in identifying STN electrode placement by comparing them with imaging and atlas based reconstruction methods.</div></div><div><h3>Methods</h3><div>LFP beta-band activity was recorded 15 days post-surgery in 59 PD patients with DBS implants. Electrode locations were classified as optimal, suboptimal, or outside the STN us-ing neuroimaging reconstructions. Clinical outcomes were assessed at one year using the Unified Parkinson's Disease Rating Scale (UPDRS I–IV).</div></div><div><h3>Results</h3><div>Beta frequency, but not magnitude, differed significantly across placement categories, with optimal electrodes showing higher beta frequency than suboptimal ones. Sensing-identified contacts showed strong concordance with neuroimaging-identified contacts across hemispheres. Op-timal electrode placements were associated with significantly greater improvements in UPDRS III Off and UPDRS IV scores, highlighting the clinical relevance of precise targeting.</div></div><div><h3>Conclusion</h3><div>Electrophysiological sensing, when integrated with imaging data, enhances the iden-tification of optimal STN contacts and supports efficient DBS programming.</div></div><div><h3>Significance</h3><div>Combining LFP recordings with neuroimaging improves programming accuracy and long-term clinical outcomes, supporting their combined use during STN-DB programming.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 766-773"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148958287","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":"Stimulated single-fiber electromyography in the diagnostic workup of diplopia and ptosis","authors":"Sara Cornacchini,&nbsp;Massimiliano Ugo Verza,&nbsp;Gregorio Spagni,&nbsp;Francesca Beretta,&nbsp;Antonio Farina,&nbsp;Maria Bastianelli,&nbsp;Annalisa Cassardo,&nbsp;Cristina Mei,&nbsp;Antonio Lotti,&nbsp;Alessandro Barilaro,&nbsp;Luca Massacesi,&nbsp;Valentina Damato,&nbsp;Antonello Grippo","doi":"10.1016/j.cnp.2026.09.004","DOIUrl":"10.1016/j.cnp.2026.09.004","url":null,"abstract":"<div><h3>Objective</h3><div>Ptosis and diplopia are common neuro-ophthalmological presentations with a broad differential diagnosis. In clinical practice, stimulated single-fiber electromyography (SFEMG) is often requested when ocular myasthenia gravis (MG) remains a diagnostic consideration after initial evaluation. This study evaluated the diagnostic contribution of stimulated SFEMG in a real-world cohort of patients referred with ptosis and/or diplopia.</div></div><div><h3>Methods</h3><div>Patients presenting with ptosis, diplopia or both were prospectively recruited and underwent comprehensive serological, radiological, and electrophysiological assessment, including SFEMG. Normative cut-offs for stimulated concentric needle SFEMG were established from 31 healthy controls and applied to the study population.</div></div><div><h3>Results</h3><div>A total of 115 patients were included (diplopia <em>n</em> = 46, ptosis <em>n</em> = 25, both <em>n</em> = 44). MG was diagnosed in 46 patients. SFEMG showed a sensitivity of 60.9% (95% CI 0.45–0.75) and specificity of 92.8% (95% CI 0.84–0.98), with a positive predictive value of 84.9% and negative predictive value of 78.1%. SFEMG identified 7 seronegative MG cases and 16 cases with negative RNS. In the non-MG group (69/115), SFEMG was negative in 92.8%, supporting its role in excluding MG.</div></div><div><h3>Conclusions</h3><div>Stimulated SFEMG demonstrates high specificity in patients with ptosis and diplopia and is particularly useful in diagnostically challenging cases, including seronegative MG and RNS-negative patients.</div></div><div><h3>Significance</h3><div>SFEMG represents a valuable second-line diagnostic tool in suspected ocular MG. Its high specificity supports its use in selected patients to confirm diagnosis and reduce the risk of MG overdiagnosis and unnecessary treatment.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 796-803"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149050328","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":"A case of low-frequency myokymia visualized by simultaneous EMG–ultrasound recording","authors":"Takamichi Sugimoto ,&nbsp;Hiroyuki Naito ,&nbsp;Keisuke Tachiyama ,&nbsp;Miharuka Yokosaki ,&nbsp;Akemi Hironaka ,&nbsp;Masahiro Nakamori ,&nbsp;Yu Yamazaki ,&nbsp;Katsumi Kurokawa ,&nbsp;Hirofumi Maruyama","doi":"10.1016/j.cnp.2026.04.007","DOIUrl":"10.1016/j.cnp.2026.04.007","url":null,"abstract":"<div><h3>Background</h3><div>Spontaneous muscle twitching observed on clinical examination can be challenging to distinguish between myokymia and fasciculation, particularly in peripheral nerve hyperexcitability syndromes where both phenomena may coexist. Because both fasciculations and myokymia may appear in Isaacs syndrome, ultrasonography alone can be misleading when discharge frequency is low, and correlation with needle EMG is essential for accurate differentiation.</div></div><div><h3>Case Presentation</h3><div>We report a 53-year-old man with an 11-year history of progressive lower-limb twitching, cramps, and nocturnal muscle pain, in whom superficial muscle contractions were difficult to classify visually. Neuromuscular ultrasound revealed spontaneous contractions in multiple muscles, but their appearance overlapped with isolated fasciculations. Simultaneous needle electromyography and ultrasound of the left vastus medialis demonstrated low-amplitude grouped discharges recurring at intervals of approximately 4–9 s, most frequently 6–8 s, with burst durations of 60–200 ms and amplitudes generally below 200 μV, findings consistent with very low–frequency myokymic discharges. Needle EMG also showed widespread fibrillation potentials, positive sharp waves, and fasciculation potentials. Based on these clinical, electrophysiological, and imaging findings, the patient met the diagnostic criteria for probable Isaacs syndrome. Treatment with intravenous methylprednisolone followed by prednisolone 10 mg/day led to improvement in muscle cramps.</div></div><div><h3>Conclusion</h3><div>This case demonstrates that visually similar ultrasonographic muscle contractions may correspond to fundamentally different electrophysiological phenomena on needle EMG, depending on the underlying pathophysiology, such as low-frequency myokymic discharges. Recognition of this distinction may help refine the interpretation of spontaneous muscle activity observed on ultrasonography and avoid oversimplified labeling as fasciculations.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 348-351"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849624","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":"Electroencephalography in stroke Care: From acute monitoring to Post-Stroke epilepsy","authors":"Vincent Leclercq ,&nbsp;Nicolas Gaspard","doi":"10.1016/j.cnp.2026.04.002","DOIUrl":"10.1016/j.cnp.2026.04.002","url":null,"abstract":"<div><div>Electroencephalography (EEG) can provide important diagnostic and prognostic information for the management of adult stroke patients. However, its integration into routine clinical practice remains variable.</div><div>During the acute phase, routine and continuous EEG (cEEG) allow the detection of nonconvulsive seizures and status epilepticus (SE), especially in patients exhibiting impaired consciousness. Rhythmic and periodic EEG patterns, such as lateralized periodic discharges (LPDs), and early epileptiform abnormalities are associated with adverse outcomes and an increased risk of acute seizures. Quantitative EEG (QEEG) metrics, including alpha-delta ratio and asymmetry indices, have the potential to identify emerging ischemia and contribute to the prognostication of functional recovery.</div><div>In the subacute and chronic stages, EEG assists in identifying patients at increased risk of post-stroke epilepsy (PSE). As such, EEG can enhance stratification and informs long-term management strategies alongside validated risk scores such as SeLECT, IsCHEMiA and CAVE.</div><div>In the long term, serial EEG and QEEG assessments can guide the titration of antiseizure medications (ASMs), detect subclinical epileptiform activity associated with PSE and monitor recovery trajectories.</div><div>Despite these contributions, evidence for EEG-guided interventions is limited, with variability in methodology, populations and protocols. Key gaps include lack of standardized strategies, limited outcome-related data and underrepresented groups. Future work should focus on multicenter trials, biomarker validation, and cost-effectiveness to clarify the role of EEG in stroke care.</div><div>This review consolidates available evidence and highlights unmet needs in EEG use during stroke management, offering practical advice for clinicians and suggesting future research priorities.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 308-320"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702536","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":"Prolonged P3 latency predicts clinical response to repetitive transcranial magnetic stimulation in tinnitus","authors":"Zhong-Ling Ding ,&nbsp;Wang-Cheng Zhou ,&nbsp;Meng-Fang Gong ,&nbsp;Ji-Sheng Liu ,&nbsp;Ya-Kang Dai ,&nbsp;Duo-Duo Tao","doi":"10.1016/j.cnp.2026.05.003","DOIUrl":"10.1016/j.cnp.2026.05.003","url":null,"abstract":"<div><h3>Objective</h3><div>The clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) for tinnitus is variable, necessitating predictive biomarkers. We assessed whether pre-treatment multimodal electroencephalography (EEG) could predict rTMS response.</div></div><div><h3>Methods</h3><div>Fifty-eight tinnitus patients underwent a 10-session rTMS protocol targeting the dorsolateral prefrontal cortex and left temporo-parietal lobe. Before treatment, we extracted a comprehensive set of 325 features, encompassing event-related potentials (ERPs), spectral power, microstate metrics, and clinical features. Predictive modeling was performed using five machine learning classifiers with 5-fold cross-validation. Feature importance was ranked, and an iterative feature selection procedure was conducted to optimize the feature set. The predictive power of the top-ranking feature was further validated by constructing a univariate model.</div></div><div><h3>Results</h3><div>Adaptive Boosting performed best. P3 latency was the top predictor. Responders had longer pre-treatment P3 latencies than non-responders (389 ms vs. 370 ms, <em>p</em> &lt; 0.001). The univariate prediction model based on a P3 latency cut-off of ≥384 ms achieved an accuracy of 0.79 and an area under the curve (AUC) of 0.69 ± 0.14. The multimodal model constructed through feature optimization, which incorporated the top 15 features, demonstrated superior predictive efficacy, achieving an accuracy of 0.84 ± 0.10 and an AUC of 0.91 ± 0.09.</div></div><div><h3>Conclusions</h3><div>Pre-treatment P3 latency robustly predicts clinical response to rTMS in tinnitus patients.</div></div><div><h3>Significance</h3><div>This study establishes P3 latency as a foundational, clinically actionable neurophysiological biomarker for stratifying rTMS response, facilitating a shift toward precision neuromodulation by optimizing patient selection and avoiding unnecessary interventions.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 381-392"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148167569","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":"Reliability of magnetoencephalography beta desynchronization for language lateralization in a subsequent memory effect paradigm","authors":"Emilie Müller,&nbsp;Paulina Riegler Vergara,&nbsp;Nadia Müller-Voggel,&nbsp;Martin Kaltenhäuser,&nbsp;Arnd Doerfler,&nbsp;Hajo Hamer,&nbsp;Daniel Delev,&nbsp;Oliver Schnell,&nbsp;Stefan Rampp","doi":"10.1016/j.cnp.2026.06.005","DOIUrl":"10.1016/j.cnp.2026.06.005","url":null,"abstract":"<div><div><strong>Objective:</strong> Verb generation is associated with significant lateralized beta desynchronization in language but also motor related areas. Subsequent Memory Effect (SME) paradigms comprise receptive language and memory tasks. The current study examined whether lateralized beta patterns in language and/or motor related areas can be obtained with the receptive SME paradigm.</div><div><strong>Methods:</strong> MEG was recorded in 20 healthy right-handed adults during encoding and recognition phases of a word SME task. Measurements were repeated after 7–10 days to assess reliability. Post-stimulus beta (13–35 Hz) decrease was analyzed, and lateralization indices (LI &gt; 0.1 indicating left dominance) were evaluated. Regions of interest (ROI) included IFG pars opercularis and triangularis (IFGO, IFGT), supramarginal gyrus, angular gyrus, superior temporal gyrus, and precentral gyrus (PreCG). An exploratory analysis included additional AAL regions.</div><div><strong>Results:</strong> Significant beta desynchronization within the ROIs was observed in 65–90% of participants. Lateralization was successful in up to 79% in the IFGT during encoding, 76% during recognition and 100% in the IFGO in encoding-recognition concordant cases. Exploratory analyses showed strong left lateralization in frontal, temporal and especially parietal areas. Initial reliability was limited, yet within-session concordance showed robust dominance with up to 100% concordance. Significant lateralized beta desynchronization was observed in the PreCG in 70–90% of participants.</div><div><strong>Conclusion:</strong> The SME paradigm shows promise in healthy participants, warranting investigation in patients with atypical language organization.</div><div><strong>Significance:</strong> Language related beta desynchronization is also observed in a receptive SME-task. Lateralized beta desynchronization in motor areas however suggest their contribution in verbal working memory and semantic control.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 472-482"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13320422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370193","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":"Post-stroke epileptic negative myoclonus: A case report with EEG-EMG back-averaging","authors":"Nicolas Broc,&nbsp;Pierre Mégevand","doi":"10.1016/j.cnp.2026.07.003","DOIUrl":"10.1016/j.cnp.2026.07.003","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 560-561"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498250","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":"An open-source JavaScript clinical neurophysiology library for education and clinical research","authors":"Sampsa Lohi ,&nbsp;Petro Julkunen ,&nbsp;Reetta Kälviäinen ,&nbsp;Esa Mervaala","doi":"10.1016/j.cnp.2026.02.001","DOIUrl":"10.1016/j.cnp.2026.02.001","url":null,"abstract":"<div><h3>Objective</h3><div>We present ‘Epicurrents’, an open-source JavaScript library for processing and displaying neurophysiological signal data in a web browser.</div></div><div><h3>Methods</h3><div>The library follows a modular architecture to enable support for multiple clinical neurophysiology modalities. It supports open standards such as the European Data Format (EDF) and Digital Imaging and Communications in Medicine (DICOM), with optional Python and Open Neural Network Exchange (ONNX) integrations for scientific signal processing. The application presented in this article is platform agnostic, requires no installation, and is usable both online and offline as a progressive web application.</div></div><div><h3>Results</h3><div>The library has been tested in real-world educational and research projects and is used by the European Academy of Neurology for hands-on EEG-education in their congresses. While JavaScript’s memory management poses limitations for processing large recordings, architectural workarounds such as shared memory buffers and asynchronous processing have resulted in improved performance.</div></div><div><h3>Conclusions</h3><div>The application presented here is not intended nor certified for clinical diagnostics, but its accessibility and extensibility make it a promising tool for neurophysiology education and research.</div></div><div><h3>Significance</h3><div>Epicurrents is the first modular JavaScript library for clinical neurophysiology education and illustrates how web technologies can also enhance collaborative scientific research in the field of clinical neurophysiology.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 115-125"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173192","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":"Brain perfusion imaging in patients with status epilepticus, seizures, and IIC patterns","authors":"Khalil S. Husari ,&nbsp;Michael Porambo ,&nbsp;Vivek S. Yedavalli ,&nbsp;Peter W. Kaplan","doi":"10.1016/j.cnp.2026.05.002","DOIUrl":"10.1016/j.cnp.2026.05.002","url":null,"abstract":"<div><div>Over the past decade, Computed Tomography perfusion (CTP) and Magnetic Resonance Perfusion (MRP) imaging have become increasingly valuable tools in the assessment of acute neurological emergencies, including stroke and stroke mimics. These modalities can demonstrate seizure-related alterations in regional cerebral blood flow across the spectrum of epileptic conditions. While ictal states classically manifest as regional hyperperfusion and interictal periods typically show hypoperfusion or normal perfusion, the perfusion patterns are more nuanced and influenced by several variables. This review examines the current literature on CTP and MRP applications in status epilepticus, seizures, and ictal-interictal continuum patterns, with particular emphasis on the comparative diagnostic accuracy across different clinical scenarios and imaging techniques.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"11 ","pages":"Pages 359-373"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147991522","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}