Martha C. Sellers, Amanda R Worrell, E. L. C. Andal, Latina R Woods, Jennifer A. Carlile, Esperanza E Wagner, Fira Berlin, Maria I de Burgo, Adrienne Rochon
{"title":"Technical Tips: Electrode Application and Preventing Skin Breakdown Techniques","authors":"Martha C. Sellers, Amanda R Worrell, E. L. C. Andal, Latina R Woods, Jennifer A. Carlile, Esperanza E Wagner, Fira Berlin, Maria I de Burgo, Adrienne Rochon","doi":"10.1080/1086508X.2011.11079821","DOIUrl":"https://doi.org/10.1080/1086508X.2011.11079821","url":null,"abstract":"ABSTRACT. The recording electrodes including their precise location, their ability to record during movements that can be intense during a convulsive seizure, and their capability to record for several days without causing skin breakdown are an integral part of long-term EEG recording. Many of the facets of EEG technology have changed dramatically with the introduction of digital EEG. But the electrode and the electrode/skin interface have not had many dramatic changes. The technologist still looks for ways to ensure correct electrode placement, good recording capabilities, and a patient with healthy skin when the electrodes are removed. This Technical Tips features ideas and experiences from several technologists. These technologists express suggestions and opinions which are accepted in Technical Tips.","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"20 1","pages":"206 - 219"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75515135","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 Report of Hereditary Neuropathy with Liability to Pressure Palsy (HNPP) Presenting with Brachial Plexopathy: The Value of Complete Electrodiagnostic Testing","authors":"S. Bulusu, H. McMillan","doi":"10.1080/1086508X.2011.11079818","DOIUrl":"https://doi.org/10.1080/1086508X.2011.11079818","url":null,"abstract":"ABSTRACT. Patients with hereditary neuropathy with liability to pressure palsy (HNPP) typically present with a mononeuropathy (particularly peroneal or ulnar palsy) or a brachial plexopathy. Careful electrodiagnostic testing has an important role in establishing the diagnosis of HNPP, differentiating this condition from other inherited or acquired neuropathies as well as obviating the need for unnecessary surgeries. We present a case of a patient who presented with a painless brachial plexopathy who was found to have multiple sites of segmental demyelination on nerve conduction studies, consistent with HNPP. We review the clinical and electrodiagnostic features of HNPP including the key electrodiagnostic findings to screen for this disorder.","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"31 1","pages":"183 - 190"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87145468","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}
Fenghua Li, E. Deshaies, Geoffrey Allott, G. Canute, R. Gorji
{"title":"Direct Cortical Stimulation But Not Transcranial Electrical Stimulation Motor Evoked Potentials Detect Brain Ischemia during Brain Tumor Resection","authors":"Fenghua Li, E. Deshaies, Geoffrey Allott, G. Canute, R. Gorji","doi":"10.1080/1086508X.2011.11079819","DOIUrl":"https://doi.org/10.1080/1086508X.2011.11079819","url":null,"abstract":"ABSTRACT. Motor evoked potentials (MEPs) elicited by both direct cortical stimulation (DCS) and transcranial electrical stimulation are used during brain tumor resection. Parallel use of direct cortical stimulation motor evoked potentials (DCS-MEPs) and transcranial electrical stimulation motor evoked potentials (TCeMEPs) has been practiced during brain tumor resection. We report that DCS-MEPs elicited by direct subdural grid stimulation, but not TCeMEPs, detected brain ischemia during brain tumor resection. Following resection of a brainstem high-grade glioma in a 21-year-old, the threshold of cortical motor-evoked-potentials (cMEPs) increased from 13 mA to 20 mA while amplitudes decreased. No changes were noted in transcranial motor evoked potentials (TCMEPs), somatosensory evoked potentials (SSEPs), auditory evoked potentials (AEPs), anesthetics, or hemodynamic parameters. Our case showed the loss of cMEPs and SSEPs, but not TCeMEPs. Permanent loss of DCS-MEPs and SSEPs was correlated with permanent left hemiplegia in our patient even when appropriate action was taken. Parallel use of DCS- and TCeMEPs with SSEPs improves sensitivity of intraoperative detection of motor impairment. DCS may be superior to TCeMEPs during brain tumor resection.","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"47 1","pages":"191 - 197"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78626450","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 report of hereditary neuropathy with liability to pressure palsy (HNPP) presenting with brachial plexopathy: the value of complete electrodiagnostic testing.","authors":"Srinivas Bulusu, Hugh J McMillan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Patients with hereditary neuropathy with liability to pressure palsy (HNPP) typically present with a mononeuropathy (particularly peroneal or ulnar palsy) or a brachial plexopathy. Careful electrodiagnostic testing has an important role in establishing the diagnosis of HNPP differentiating this condition from other inherited or acquired neuropathies as well as obviating the need for unnecessary surgeries. We present a case of a patient who presented with a painless brachial plexopathy who was found to have multiple sites of segmental demyelination on nerve conduction studies, consistent with HNPP. We review the clinical and electrodiagnostic features of HNPP including the key electrodiagnostic findings to screen for this disorder.</p>","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"51 3","pages":"183-90"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30198664","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}
Ryan R Lau, Mary K Powell, Colin Terry, Derek Jahnke
{"title":"Neurotelemetry electrode application techniques compared.","authors":"Ryan R Lau, Mary K Powell, Colin Terry, Derek Jahnke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The secure and efficient affixation of EEG electrodes is an integral part of performing neurotelemetry; however there are currently no recommendations for the ideal method of affixing the electrodes that has evidence-based support. The purpose of this study was to find and determine the best hook up method based on the required hook up time and number of repairs. One hundred neurotelemetry patients were randomly assigned to one of the following four electrode application methods: collodion-Ten20, collodion-Elefix, Hypafix-Ten20, or Hypafix-Elefix. The collodion-Ten20 method had the longest average hook up time (53.7 min) and the lowest percentage of patients who needed repairs (24%); the Hypafix-Ten20 method had the shortest average hook up time (42.1 min); and the Hypafix-Elefix had the highest percentage of patients who needed repairs (86.4%). Based on these results, the study led to the recommendations that collodion-Ten20 be used for neurotelemetry studies lasting 24 hours or more and that Hypafix is more suitable for routine EEG studies.</p>","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"51 3","pages":"165-82"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30198663","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}
Fira Berlin, Jennifer A Carlile, Maria I de Burgo, Adrienne Rochon, Esperanza E Wagner, Martha C Sellers, Amanda R Worrell, E Lauren C Andal, Latina R Woods
{"title":"Technical tips: Electrode application and preventing skin breakdown techniques.","authors":"Fira Berlin, Jennifer A Carlile, Maria I de Burgo, Adrienne Rochon, Esperanza E Wagner, Martha C Sellers, Amanda R Worrell, E Lauren C Andal, Latina R Woods","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The recording electrodes including their precise location, their ability to record during movements that can be intense during a convulsive seizure, and their capability to record for several days without causing skin breakdown are an integral part of long-term EEG recording. Many of the facets of EEG technology have changed dramatically with the introduction of digital EEG. But the electrode and the electrode/skin interface have not had many dramatic changes. The technologist still looks for ways to ensure correct electrode placement, good recording capabilities, and a patient with healthy skin when the electrodes are removed. This Technical Tips features ideas and experiences from several technologists. These technologists express suggestions and opinions which are accepted in Technical Tips.</p>","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"51 3","pages":"206-19"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30199637","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}
F. Jahangiri, Andrea Flolmberg, F. Vega–Bermudez, V. Arlet
{"title":"Preventing Position-Related Brachial Plexus Injury with Intraoperative Somatosensory Evoked Potentials and Transcranial Electrical Motor Evoked Potentials during Anterior Cervical Spine Surgery","authors":"F. Jahangiri, Andrea Flolmberg, F. Vega–Bermudez, V. Arlet","doi":"10.1080/1086508X.2011.11079820","DOIUrl":"https://doi.org/10.1080/1086508X.2011.11079820","url":null,"abstract":"ABSTRACT. The use of somatosensory evoked potentials (SSEPs) to monitor upper extremity nerves during surgery is becoming more accepted as a valid and useful technique to minimize intraoperative nerve injuries. We present a case illustrating the benefit of utilizing both SSEPs and transcranial electrical motor evoked potentials (TCeMEPs) for preventing position-related injury during surgery. The patient was a 43-year-old male with a history of neck pain, along with numbness and tingling of the upper extremities. While the patient was being draped, upper extremity SSEPs diminished significantly. TCeMEP responses in the hands (abductor pollicus brevis-abductor digiti minimi; APB-ADM) vanished shortly after that, followed by the biceps and left deltoid. The surgeons were notified, and the tape on the shoulders was loosened. No improvements were noted in SSEPs nor TCeMEPs due to this intervention, so all tape was removed and the patient's arms were allowed to rest naturally upon the arm boards. Upper extremity TCeMEP responses could then be elicited and SSEPs improved shortly afterward. Surgery was completed with the arms on the arm boards. All signals remained stable for the remaining three hours of the procedure. At two months follow-up, the patient was well with total pain relief and normal upper extremity function when neurological examination was performed. This report demonstrates a case in which intraoperative neurophysiological monitoring was useful in identifying and reversing impending nerve injury during cervical spine surgery. Significant changes were seen in SSEPs as well as TCeMEPs, so we recommend that TCeMEP monitoring be considered as an adjunct to SSEPs for prevention of injury to the brachial plexus.","PeriodicalId":7480,"journal":{"name":"American Journal of Electroneurodiagnostic Technology","volume":"33 1","pages":"198 - 205"},"PeriodicalIF":0.0,"publicationDate":"2011-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85462362","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}