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Intraoperative Monitoring of the External Urethral Sphincter Reflex: A Novel Adjunct to Bulbocavernosus Reflex Neuromonitoring for Protecting the Sacral Neural Pathways Responsible for Urination, Defecation and Sexual Function. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-11-09 Justin W Silverstein,Jon Block,Zachary T Olmsted,Ross Green,Thomas Pieters,Kristiana Babarevech,Alicia Ballas-Williamson,Stanley A Skinner,Daniel M Sciubba,Sheng-Fu Larry Lo
PURPOSE Intraoperative bulbocavernosus reflex neuromonitoring has been utilized to protect bowel, bladder, and sexual function, providing a continuous functional assessment of the somatic sacral nervous system during surgeries where it is at risk. Bulbocavernosus reflex data may also provide additional functional insight, including an evaluation for spinal shock, distinguishing upper versus lower motor
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Comparison Between Cz-C3/C4 and C3-C4 Montages to Protect Against Peripheral Stimulation in Transcranial Facial Motor-Evoked Potential Monitoring. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-11-09 Ryuta Matsuoka,Naoya Hamada,Nobuyuki Nishimura,Takaaki Mitsui,Yuki Shiraishi,Hiromichi Hayami,Kenji Fukutome,Rinsei Tei,Yasushi Shin,Shuta Aketa,Daizo Kato,Takashi Kita,Yasushi Motoyama
INTRODUCTION In facial motor-evoked potential monitoring, efforts to reduce peripheral stimulation are necessary because it can cause false-negatives. The effects of peripheral stimulation on Cz-C3/C4 and C3-C4 montages were compared. METHODS Facial motor-evoked potentials were recorded from bilateral orbicularis oculi (Oculi) and oris (Oris) muscles. The double-train approach combining single-pulse
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Real-World Continuous EEG Utilization and Outcomes in Hospitalized Patients With Acute Cerebrovascular Diseases. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-10-30 Rajesh Amerineni,Haoqi Sun,Marta Bento Fernandes,M Brandon Westover,Lidia Moura,Elisabetta Patorno,John Hsu,Sahar F Zafar
PURPOSE Continuous electroencephalography (cEEG) is recommended for hospitalized patients with cerebrovascular diseases and suspected seizures or unexplained neurologic decline. We sought to (1) identify areas of practice variation in cEEG utilization, (2) determine predictors of cEEG utilization, (3) evaluate whether cEEG utilization is associated with outcomes in patients with cerebrovascular diseases
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Correlations Between Quantitative EEG Parameters and Cortical Blood Flow in Patients Undergoing Extracorporeal Membrane Oxygenation With and Without Encephalopathy. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-10-30 Imad R Khan,Irfaan A Dar,Thomas W Johnson,Emily Loose,Yama Y Xu,Esmeralda Santiago,Kelly L Donohue,Mark A Marinescu,Igor Gosev,Giovanni Schifitto,Ross K Maddox,David R Busch,Regine Choe,Olga Selioutski
PURPOSE The neurologic examination of patients undergoing extracorporeal membrane oxygenation (ECMO) is crucial for evaluating irreversible encephalopathy but is often obscured by sedation or neuromuscular blockade. Noninvasive neuromonitoring modalities including diffuse correlation spectroscopy and EEG measure cerebral perfusion and neuronal function, respectively. We hypothesized that encephalopathic
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Long-Term Intracranial EEG Lateralization of Epileptogenicity in Patients With Confirmed or Suspected Bilateral Mesial Temporal Lobe Onsets During Epilepsy Surgical Evaluation. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-10-30 Amir M Arain,Emily A Mirro,Dan Brown,Angela Peters,Blake Newman,Sindhu Richards,John D Rolston
PURPOSE The data resulting from epilepsy surgical evaluation are occasionally unclear in cases of mesial temporal lobe (MTL) epilepsy. Long-term intracranial EEG (iEEG) collected by the Responsive Neurostimulation (RNS) System may be an approach for capturing additional seizure data while treating patients with neurostimulation. We reviewed iEEG seizure lateralization and clinical outcomes in bilateral
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Comparison of Automated Spike Detection Software in Detecting Epileptiform Abnormalities on Scalp-EEG of Genetic Generalized Epilepsy Patients. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-10-30 Mubeen Janmohamed,Duong Nhu,Lubna Shakathreh,Ofer Gonen,Levin Kuhlman,Amanda Gilligan,Chang Wei Tan,Piero Perucca,Terence J O'Brien,Patrick Kwan
PURPOSE Despite availability of commercial EEG software for automated epileptiform detection, validation on real-world EEG datasets is lacking. Performance evaluation of two software packages on a large EEG dataset of patients with genetic generalized epilepsy was performed. METHODS Three epileptologists labelled IEDs manually of EEGs from three centres. All Interictal epileptiform discharge (IED)
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Neurophysiological and Clinical Outcomes in Episodic Migraine Without Aura: A Cross-Sectional Study. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-10-30 Manuela Deodato,Antonio Granato,Miriam Martini,Alex Bouite Stella,Alessandra Galmonte,Luigi Murena,Paolo Manganotti
OBJECTIVE The aim of this study was to assess differences between people with episodic migraine and healthy controls in some neurophysiological and clinical outcomes, which, in turn, may highlight the differences in sensory processing, especially in cortical excitability, pain processing, and executive function. METHODS A cross-sectional study was performed, including the following outcomes: pressure
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Effect of Sevoflurane Anesthesia on Intraoperative Spikes, High-Frequency Oscillations, and Phase-Amplitude Coupling in MRI-Normal Hippocampus. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-10-30 Riju Dahal,Kentaro Tamura,Dong-Sheng Pan,Ryota Sasaki,Yasuhiro Takeshima,Ryosuke Matsuda,Shuichi Yamada,Fumihiko Nishimura,Ichiro Nakagawa,Young-Soo Park,Hironobu Hayashi,Masahiko Kawaguchi,Hiroyuki Nakase
INTRODUCTION The purpose of this study was to determine the effect of sevoflurane anesthesia on spikes, high-frequency oscillations (HFOs), and phase-amplitude coupling using a modulation index in MRI-normal hippocampus, with the aim of evaluating the utility of intraoperative electrocorticography in identifying the epileptogenic hippocampus during sevoflurane administration. METHODS Eleven patients
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Association of Scalp High-Frequency Oscillation Detection and Characteristics With Disease Activity in Pediatric Epilepsy. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-10-30 Keisuke Maeda,Nami Hosoda,Junichi Fukumoto,Shun Kawai,Mizuki Hayafuji,Himari Tsuboi,Shiho Fujita,Naohiro Ichino,Keisuke Osakabe,Keiko Sugimoto,Naoko Ishihara
INTRODUCTION High-frequency oscillation (HFO) in scalp electroencephalography is a promising new noninvasive prognostic epilepsy biomarker, but further data are needed to ascertain the utility of this parameter. The present work investigated the association between epileptic activity and scalp HFO in pediatric patients with various types of epilepsy, using multivariable regression models to correct
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Four State Sleep Staging From a Multilayered Algorithm Using Electrocardiographic and Actigraphic Data. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-10-05 Mario Garingo,Chaim Katz,Kramay Patel,Stephan Meyer Zum Alten Borgloh,Parisa Sabetian,Jeffrey Durmer,Sharon Chiang,Vikram R Rao,John M Stern
PURPOSE Sleep studies are important to evaluate sleep and sleep-related disorders. The standard test for evaluating sleep is polysomnography, during which several physiological signals are recorded separately and simultaneously with specialized equipment that requires a technologist. Simpler recordings that can model the results of a polysomnography would provide the benefit of expanding the possibilities
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The Utility of Motor Evoked Potential Monitoring for Predicting Postoperative Motor Deficit in Patients With Insular Gliomas. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-10-05 Xing Fan,Hao You,Jiajia Liu,Xiaorong Tao,Mingran Wang,Ke Li,Jun Yang,Jian Xie,Hui Qiao
PURPOSE Motor evoked potential (MEP) monitoring has been widely applied in various neurosurgical operations. This study aimed to assess the predictive value of MEP monitoring for postoperative motor deficit (PMD) in patients with insular gliomas. METHODS Demographic and clinical data, MEP monitoring data, and follow-up data of 42 insular glioma patients were retrospectively reviewed, and 40 patients
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Correlation Between Quantitative Background Suppression on EEG and Serum NSE in Patients With Hypoxic-ischemic Encephalopathy. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-09-25 Dong Ah Lee,Gyeong Mo Sohn,Byung Joon Kim,Byung Chul Yoo,Jae Hyeok Lee,Hyun Ju Choi,Sung Eun Kim
PURPOSE We evaluated the correlation between quantitative background activities on electroencephalography (EEG) and serum neuron specific enolase (NSE) in patients with hypoxic-ischemic encephalopathy as well as a diagnostic value of prognostication. METHODS This retrospective cohort study enrolled patients with return of spontaneous circulation after cardiac arrest from March 2010 to March 2020. The
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Diagnostic Value of Intermittent Photic Stimulation Among Adult Patients in a Tertiary Referral Epilepsy Center: A Retrospective Study. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-09-25 Bernhard J Steinhoff,Tassanai Intravooth,Jitender Gupta,Viviane Bernedo-Paredes,Patricia Mahn,Jakob Stockinger,Peter Martin,Anke M Staack
PURPOSE Photosensitivity is a phenomenon that may be elicited by standardized intermittent photic stimulation during EEG recording and is detected more frequently in children and adolescents. Nevertheless, at our Epilepsy Center, we routinely assess photosensitivity in all newly referred adult patients. In this investigation, we sought to address the diagnostic yield under the prerequisites described
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EEG Source Localization in Temporal Encephaloceles: Concordance With Surgical Resection and Clinical Outcomes. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-09-22 Benjamin C Cox,Shruti H Agashe,Kelsey M Smith,Kiran M Kanth,Jamie J Van Gompel,Karl N Krecke,Robert J Witte,Lily C Wong-Kisiel,Benjamin H Brinkmann
PURPOSE Temporal encephaloceles are a cause of drug-resistant temporal lobe epilepsy; however, their relationship with epileptogenesis is unclear, and optimal surgical resection is uncertain. EEG source localization (ESL) may guide surgical decision-making. METHODS We reviewed patients at Mayo Clinic Rochester with drug-resistant temporal lobe epilepsy and temporal encephaloceles, who underwent limited
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ACNS 2022 Annual Meeting: E-Poster Abstracts. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-09-01
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Usefulness of the H-Reflex for Intraoperative Monitoring of Thoracoabdominal Aneurysms. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-05-26 Guillermo Martín-Palomeque,Lidia Cabañes-Martínez,Jaime R López,Raidili Cristina Mateo Montero,Andrés Reyes,Claudio Gandarias,Ignacio Regidor
PURPOSE Intraoperative neurophysiologic monitoring in thoracoabdominal aneurysms (TAAA) is essential to avoid intraoperative spinal cord injury). Motor and somatosensory evoked potentials may be considered intraoperative tools for detecting spinal cord injury. H-reflex is a well-known neurophysiologic technique to evaluate L5-S1 root. Current evidence supports the observation that H-reflex changes
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Quantitative Electroencephalographic Changes Associated With Brain Tissue Hypoxia After Pediatric Traumatic Brain Injury: A Retrospective Exploratory Analysis. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-05-16 Brian L Appavu,M Hamed Temkit,Damla Hanalioglu,Brian T Burrows,P David Adelson
PURPOSE Brain tissue hypoxia is associated with poor outcomes after pediatric traumatic brain injury. Although invasive brain oxygenation (PbtO2) monitoring is available, noninvasive methods assessing correlates to brain tissue hypoxia are needed. We investigated EEG characteristics associated with brain tissue hypoxia. METHODS We performed a retrospective analysis of 19 pediatric traumatic brain injury
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High Effectiveness of Midazolam and Lidocaine in the Treatment of Acute Neonatal Seizures J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-04-25 José Ramón Castro Conde, Candelaria González Campo, Desiré González Barrios, Beatriz Reyes Millán, Candelaria Leticia Díaz González, Alejandro Jiménez Sosa
Purpose: To assess the clinical effectiveness of treating acute seizures with midazolam and lidocaine infusion. Methods: This single-center historical cohort study included 39 term neonates with electrographic seizures who underwent treatment with midazolam (1st line) and lidocaine (2nd line). Therapeutic response was measured using continuous video-EEG monitoring. The EEG measurements included total
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High Effectiveness of Midazolam and Lidocaine in the Treatment of Acute Neonatal Seizures. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-04-25 José Ramón Castro Conde,Candelaria González Campo,Desiré González Barrios,Beatriz Reyes Millán,Candelaria Leticia Díaz González,Alejandro Jiménez Sosa
PURPOSE To assess the clinical effectiveness of treating acute seizures with midazolam and lidocaine infusion. METHODS This single-center historical cohort study included 39 term neonates with electrographic seizures who underwent treatment with midazolam (1st line) and lidocaine (2nd line). Therapeutic response was measured using continuous video-EEG monitoring. The EEG measurements included total
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Cervical Radiofrequency Ablation Artifact Mimicking an Electrographic Seizure on RNS J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-04-17 Sofía S. Sánchez-Boluarte, Anteneh M. Feyissa, Brin Freund, Aafreen Khan, Erik H. Middlebrooks, Sanjeet S. Grewal, William O. Tatum
Summary: The responsive neurostimulator continuously monitors the electrocorticogram. It delivers short bursts of high-frequency electrical stimulation when personalized patterns are detected. Intracranial EEG recording including electrocorticography is susceptible to artifacts, albeit at a lesser frequency compared with scalp recording. The authors describe a novel case of a patient with focal epilepsy
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Macroperiodic Oscillations: A Potential Novel Biomarker of Outcome in Neonatal Encephalopathy. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-04-12 Jennifer C Keene,Maren E Loe,Talie Fulton,Maire Keene,Amit Mathur,Michael J Morrissey,Stuart R Tomko,Zachary A Vesoulis,John M Zempel,ShiNung Ching,Réjean M Guerriero
PURPOSE Neonatal encephalopathy (NE) is a common cause of neurodevelopmental morbidity. Tools to accurately predict outcomes after therapeutic hypothermia remain limited. We evaluated a novel EEG biomarker, macroperiodic oscillations (MOs), to predict neurodevelopmental outcomes. METHODS We conducted a secondary analysis of a randomized controlled trial of neonates with moderate-to-severe NE who underwent
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Clinical and Electrophysiological Characteristics of Very Early Guillain-Barré Syndrome. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-04-06 Mritunjai Kumar,Nikita Dhar,Ashutosh Tiwari,Jagbir Singh,Vinayak Jatale
PURPOSE This study compared the clinical and electrodiagnostic (EDX) features and long-term outcomes of patients with very early Guillain-Barré syndrome (VEGBS, duration of illness ≤4 days) and those with early/late (>4 days)-presenting GBS. METHODS One hundred patients with GBS were clinically evaluated and categorized into VEGBS and early/late GBS groups. Electrodiagnostic studies were performed
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Insights From Chronic ECoG by RNS. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-30 Christopher B Traner,David King-Stephens
The NeuroPace responsive neurostimulation system (RNS) has revolutionized the care of patients suffering from focal epilepsy since its approval in 2014. One major advantage of this device is its innate ability to gather long-term electrocorticographic (ECoG) data that the device uses in its novel closed-loop treatment paradigm. Beyond the standard stimulation treatments, which have been demonstrated
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Guidelines for Qualifications of Neurodiagnostic Personnel: A Joint Position Statement of the American Clinical Neurophysiology Society, the American Association of Neuromuscular & Electrodiagnostic Medicine, the American Society of Neurophysiological Monitoring, and ASET—The Neurodiagnostic Society J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-24 Jaime R. López, Judy Ahn-Ewing, Ron Emerson, Carrie Ford, Clare Gale, Jeffery H. Gertsch, Lillian Hewitt, Aatif Husain, Linda Kelly, John Kincaid, Meledy Kise, Adam Kornegay, Joseph J. Moreira, Marc Nuwer, Anita Schneider, Mark Stecker, Lucy R. Sullivan, J. Richard Toleikis, Lois Wall, Susan Herman
Summary: The Guidelines for Qualifications of Neurodiagnostic Personnel (QNP) document has been created through the collaboration of the American Clinical Neurophysiology Society (ACNS), the American Society of Neurophysiological Monitoring (ASNM), the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM), and ASET—The Neurodiagnostic Society (ASET). The quality of patient care
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Guidelines for Qualifications of Neurodiagnostic Personnel: A Joint Position Statement of the American Clinical Neurophysiology Society, the American Association of Neuromuscular & Electrodiagnostic Medicine, the American Society of Neurophysiological Monitoring, and ASET-The Neurodiagnostic Society. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-24 Jaime R López,Judy Ahn-Ewing,Ron Emerson,Carrie Ford,Clare Gale,Jeffery H Gertsch,Lillian Hewitt,Aatif Husain,Linda Kelly,John Kincaid,Meledy Kise,Adam Kornegay,Joseph J Moreira,Marc Nuwer,Anita Schneider,Mark Stecker,Lucy R Sullivan,J Richard Toleikis,Lois Wall,Susan Herman
The Guidelines for Qualifications of Neurodiagnostic Personnel (QNP) document has been created through the collaboration of the American Clinical Neurophysiology Society (ACNS), the American Society of Neurophysiological Monitoring (ASNM), the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM), and ASET-The Neurodiagnostic Society (ASET). The quality of patient care is optimized
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Mapping the Central Sulcus Extraoperatively Using Stereoelectroencephalography: A New Application of an Established Method. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-24 Ammar Kheder,Ruba Al-Ramadhani,Sonam Bhalla,Adam Dickey,Abdulrahman Alwaki,Joshua Chern,Nigel Pederson,Satyanarayana Gedela
PURPOSE Central sulcus localization is undertaken intraoperatively with subdural electrodes through a phase reversal technique using somatosensory evoked potentials from sensorimotor cortices. Extraoperative central sulcus localization using stereoelectroencephalography has not been described previously. METHODS Six pediatric patients (aged 12-18 years, 50% females) were investigated with stereoel
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Motor Evoked Potential-A Pilot Study Looking at Reliability and Clinical Correlations in Multiple Sclerosis. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-21 F H Jacques,B E Apedaile,I Danis,V Sikati-Foko,M Lecompte,J Fortin
PURPOSE Multiple sclerosis (MS) is a clinically heterogeneous disease. Biomarkers that can assess pathological processes that are unseen with conventional imaging remain an unmet need in MS disease management. Motor evoked potentials (MEPs) could be such a biomarker. To determine and follow longitudinal MEP reliability and correlations with clinical measures in MS patients. METHODS This is a single-center
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Sleep/Wake Disorders After Sports Concussion: Risks, Revelations, and Interventions. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-16 Madeleine M Grigg-Damberger
Sleep-wake disturbances (SWDs) are among the most prevalent, persistent, and often disregarded sequelae of traumatic brain injury. Identification and treatment of SWDs in patients with traumatic brain injury is important and can complement other efforts to promote maximum functional recovery. SWDs can accentuate other consequences of traumatic brain injury, negatively affect mood, exacerbate pain,
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Cingulate Epilepsy: A Not so Singular World. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-15 Dang Khoa Nguyen
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Neurophysiological Markers to Guide Return to Sport After Sport-Related Concussion. J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-15 Jessica Coenen,Claus Reinsberger
Sport-related concussion (SRC) has been defined as a subset of mild traumatic brain injury (mTBI), without structural abnormalities, reflecting a functional disturbance. Over the past decade, SRC has gained increasing awareness and attention, which coincides with an increase in incidence rates. Because this injury has been considered one of the most challenging encounters for clinicians, there is a
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A Concise Review of Polysomnography and Obstructive Sleep Apnea for the Neurophysiologist J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-01 Marjorie E. Soltis, Andrew R. Spector
Summary: Sleep as an electrical phenomenon in the brain was first recorded in 1875. Over the next 100 years, recordings of sleep evolved into modern-day polysomnography, which includes not only electroencephalography but also combinations of electro-oculography, electromyography, nasal pressure transducers, oronasal airflow monitors, thermistors, respiratory inductance plethysmography, and oximetry
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Objective Diagnosis of Circadian Rhythm Disorders J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-01 Alessandra Giordano, Jeanne Duffy, Lawrence J. Epstein, Milena K. Pavlova
Summary: Circadian sleep–wake disorders are common. Because they represent conflict between the timing of the patient's endogenous rhythms and desired timing of sleep, the presenting complaints may include both difficulty of sleep initiation or maintenance and undesired or unplanned daytime or early evening sleepiness. Therefore, circadian disorders may be misdiagnosed as either a primary insomnia
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Electroclinical Presentations of Fixation-off Sensitivity in Adults With Symptomatic Epilepsy J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-01 Leyla Das Pektezel, F. Irsel Tezer, Serap Saygi
Purpose: Fixation-off sensitivity (FOS) is a discharge pattern on EEG that occurs owing to the loss of central vision or fixation. Knowledge regarding the relationship between FOS and symptomatic epilepsy is limited. Therefore, we aimed to evaluate the electroclinical features of FOS in adult patients with symptomatic epilepsy. Methods: Outpatient video-EEG records of the Hacettepe University Faculty
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Oscillatory EEG-TMS Reactivity in Parkinson Disease J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-01 Emanuela Formaggio, Michele Tonellato, Angelo Antonini, Leonora Castiglia, Laura Gallo, Paolo Manganotti, Stefano Masiero, Alessandra Del Felice
Purpose: A dysfunction of beta oscillatory activity is the neurophysiological hallmark of Parkinson disease (PD). How cortical activity reacts to external perturbations may provide insight into pathophysiological mechanisms. This study aims at identifying modifications in EEG rhythms after transcranial magnetic stimulation (TMS) in PD. We hypothesize that single-pulse TMS can modulate brain intrinsic
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Out of the Laboratory and into the Home: Home Testing for Sleep Apnea and Other Sleep Disorders J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-01 Brynn K. Dredla, Pablo R. Castillo
Summary: Home sleep testing has emerged over the past decade and become an intriguing option for patients and providers because it can be conducted in the home environment. However, appropriate application of this technology is key to ensure accurate and validated results to provide appropriate patient care. In this review, we will cover the current guidelines for the use of home sleep apnea tests
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Multiple Sleep Latency Test/Maintenance of Wakefulness Test and Central Hypersomnias: Evolving Diagnostic and Therapeutic Approaches J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-01 Ajay C. Sampat, Alon Y. Avidan
Summary: Central disorders of hypersomnolence include a spectrum of conditions, such as narcolepsy, idiopathic hypersomnia, and Kleine–Levin syndrome, in which excessive daytime sleepiness is the primary feature. Subjective testing with tools, such as sleep logs and sleepiness scales, are often helpful in the evaluation of these disorders but do not necessarily correlate well with objective testing
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Restless Legs Syndrome and Periodic Limb Movements of Sleep: From Neurophysiology to Clinical Practice J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-01 Ioanna Kouri, Mithri R. Junna, Melissa C. Lipford
Summary: This article summarizes restless legs syndrome (RLS), periodic limb movements of sleep, and periodic limb movement disorder. RLS is a common sleep disorder with a prevalence of 5% to 15% in the general population. RLS can present in childhood, and incidence increases with age. RLS can be idiopathic or secondary to iron deficiency, chronic renal failure, peripheral neuropathy, and medications
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Nonrapid Eye Movement Parasomnias J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-01 Ann Augustine
Summary: Non-REM parasomnias are often observed during childhood and adolescence, by which time they typically remit. For a small percentage, these nocturnal behaviors can persist into adulthood, or in some cases, present as a new onset in adults. Non-REM parasomnias (also known as disorders of arousal) can offer a diagnostic challenge in patients who have an atypical presentation where REM sleep
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EEG Biomarkers of Repository Corticotropin Injection Treatment J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-01 Ahmet Tanritanir, Solveig Vieluf, Saba Jafarpour, Xiaofan Wang, Tobias Loddenkemper
Purpose: Hypsarrhythmia is one of the major diagnostic and treatment response criteria in infantile spasms (IS). The clinical and electrophysiological effect of repository corticotropin injection treatment on IS was evaluated using electrophysiological biomarkers. Methods: Consecutive infants (<24 months) treated with repository corticotropin injection for IS were included in this retrospective descriptive
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Comparison of Clinical, Ultrasound, and Electrophysiologic Changes in Chronic Inflammatory Demyelinating Polyneuropathy: A Prospective Study J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-01 Ali Asghar Okhovat, Shahriar Nafissi, Kamyar Moradi, Bentolhoda Ziaadini, Akram Panahi, Bahram Haghi Ashtiani, Farzad Fatehi
Purpose: The follow-up and monitoring of response to immunomodulatory therapy in patients with chronic inflammatory demyelinating polyneuropathy are still challenging. Various outcome measures have been proposed in recent years, and some are now frequently used in daily clinical practice; however, reliable biomarkers for the disease activity and treatment response are lacking. Methods: Cross-sectional
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Sleep Neurology: Is It a Ready for Prime Time Player? J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-01 Erik K St Louis
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Intracranial Pressure Fluctuations Mimicking Seizures in a Patient With Shunt Malfunction J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-01 Sergiu Abramovici, Kaitlyn Blackburn, Trevor Phinney, Lazarus Mayoglou
Summary: This case describes a patient with new onset of multiple daily paroxysmal stereotyped episodes with alteration of arousal and responsiveness. These episodes pose a diagnostic challenge because they may be misdiagnosed as epileptic seizures because of stereotypy, similarities in semiology, risk factors such as structural abnormality, and rhythmic EEG pattern. A 20-year-old woman with Chiari
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Motor Evoked Potentials in Newly Diagnosed and Treated Patients With Wilson Disease J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-03-01 Jan P. Bembenek, Katarzyna Kurczych, Bożena Kłysz, Łukasz Smoliński, Tomasz Litwin, Anna Członkowska
Purpose: To investigate whether patients with Wilson disease have abnormal motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation. Methods: In a prospective, observational, single-center study, transcranial magnetic stimulation was used to examine MEPs recorded from the abductor digiti minimi in 24 newly diagnosed treatment-naive patients and 21 treated patients with Wilson
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Spike-Associated Networks Predict Postsurgical Outcomes in Children With Refractory Epilepsy J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Joshua J. Bear, Jenifer L. Sargent, Brent R. O'Neill, Kevin E. Chapman, Debashis Ghosh, Heidi E. Kirsch, Jason R. Tregellas
Purpose: Up to half of the children undergoing epilepsy surgery will continue to have seizures (szs) despite a cortical resection or ablation. Functional connectivity has shown promise in better identifying the epileptogenic zone. We hypothesized that cortical areas showing high information outflow during interictal epileptiform discharges are part of the epileptogenic zone. Methods: We identified
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Sporadic and Periodic Interictal Discharges in Critically Ill Children: Seizure Associations and Time to Seizure Identification J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Arnold J. Sansevere, Melissa L. DiBacco, Bo Zhang, Alireza Akhondi-Asl, Mark H. Libenson, Robert C. Tasker, Phillip L. Pearl
Purpose: We evaluated interictal discharges (IEDs) as a biomarker for the time to development of electrographic seizures (ES). Methods: Prospective observational study of 254 critically ill children who underwent continuous electroencephalography (cEEG) monitoring. We excluded neonates and patients with known epilepsy or the sole cEEG indication to characterize events. Interictal discharges included
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Tonic Seizures in a Patient With Lennox–Gastaut Syndrome Manifest as “Icicles” Rather Than “Flames” on Quantitative EEG Analysis J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Eva Catenaccio, Mariko L. Bennett, Shavonne L. Massey, Nicholas S. Abend, Christina Bergqvist
Summary: Quantitative analysis of continuous electroencephalography (QEEG) is increasingly being used to augment seizure detection in critically ill patients. Typically, seizures manifest on QEEG as abrupt increases in power and frequency, a visual pattern often called “flames.” Here, we present a case of a 16-year-old patient with intractable Lennox–Gastaut syndrome secondary to a pathogenic variant
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Neurophysiology of Juvenile and Progressive Myoclonic Epilepsy J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Jayant N. Acharya, Vinita J. Acharya
Summary: Myoclonus can be epileptic or nonepileptic. Epileptic myoclonus has been defined in clinical, neurophysiological, and neuroanatomical terms. Juvenile myoclonic epilepsy (JME) is typically considered to be an adolescent-onset idiopathic generalized epilepsy with a combination of myoclonic, generalized tonic–clonic, and absence seizures and normal cognitive status that responds well to anti-seizure
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Myoclonus as a Manifestation of Reflex Seizures J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Charles Akos Szabo, Dorothee Kasteleijn
Summary: Myoclonus is a motor symptom commonly associated with reflex seizures in people with idiopathic generalized epilepsies. The most frequently observed triggers of myoclonus are related to visual stimuli, including flashing lights or patterns; nonetheless, myoclonus can also be activated by movement, speech or reading, calculations, and praxis. Reflex myoclonic seizures may be the hallmark of
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Neurophysiological and Clinical Correlates of Acute Posthypoxic Myoclonus J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Brin E. Freund, Peter W. Kaplan
Summary: Prognostication following cardiorespiratory arrest relies on the neurological examination, which is supported by neuroimaging and neurophysiological testing. Acute posthypoxic myoclonus (PHM) is a clinical entity that has prognostic significance and historically has been considered an indicator of poor outcome, but this is not invariably the case. “Malignant” and more “benign” forms of acute
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Theta-Alpha Variability on Admission EEG Is Associated With Outcome in Pediatric Cerebral Malaria J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Alexander Andrews, Tesfaye Zelleke, Dana Harrar, Rima Izem, Jiaxiang Gai, Douglas Postels
Purpose: Pediatric cerebral malaria has high rates of mortality and neurologic morbidity. Although several biomarkers, including EEG, are associated with survival or morbidity, many are resource intensive or require skilled interpretation for clinical use. Automation of quantitative interpretation of EEG may be preferable in resource-limited settings, where trained interpreters are rare. As currently
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Manifestation of Hippocampal Interictal Discharges on Clinical Scalp EEG Recordings J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Somin Lee, Shasha Wu, James X. Tao, Sandra Rose, Peter C. Warnke, Naoum P. Issa, Wim van Drongelen
Purpose: Epileptiform activity limited to deep sources such as the hippocampus currently lacks reliable scalp correlates. Recent studies, however, have found that a subset of hippocampal interictal discharges may be associated with visible scalp signals, suggesting that some types of hippocampal activity may be monitored noninvasively. The purpose of this study is to characterize the relationship
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Machine Learning to Classify Relative Seizure Frequency From Chronic Electrocorticography J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Yueqiu Sun, Daniel Friedman, Patricia Dugan, Manisha Holmes, Xiaojing Wu, Anli Liu
Purpose: Brain responsive neurostimulation (NeuroPace) treats patients with refractory focal epilepsy and provides chronic electrocorticography (ECoG). We explored how machine learning algorithms applied to interictal ECoG could assess clinical response to changes in neurostimulation parameters. Methods: We identified five responsive neurostimulation patients each with ≥200 continuous days of stable
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Quantitative EEG as a Prognostic Tool in Suspected Anti-N-Methyl-d-Aspartate Receptor Antibody Encephalitis J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Graham Blackman, Kieron Kumar, John G. Hanrahan, Anthony Dalrymple, Nandini Mullatti, Nick Moran, Antonio Valentin, Lucy Gibson, Thomas A. Pollak, Anthony S. David
Purpose: Anti–N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis is a form of autoimmune encephalitis associated with EEG abnormalities. In view of the potentially severe outcomes, there is a need to develop prognostic tools to inform clinical management. The authors explored whether quantitative EEG was able to predict outcomes in patients with suspected anti-NMDAR encephalitis. Methods: A
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Are We Underestimating the Central Components of the Mixed Apneas?—A Hypothesis for Revised Scoring J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Gülçin Benbir Şenel, Ceren Aliş, Derya Karadeniz
Purpose: Apneas are classified in three categories, as obstructive, central, and mixed types. Mixed apneas are calculated together with the obstructive events in diagnosing obstructive sleep apnea syndrome (SAS). The clinical significance of mixed apneas needs to be specified. Methods: Patients with obstructive SAS having an index of mixed apneas ≥5/hour were evaluated. A new approach was developed
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A Randomized Controlled Trial of the Effect of Repetitive Transcranial Magnetic Stimulation of the Motor Cortex on Lower Extremity Spasticity in Hereditary Spastic Paraplegia J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Pouya B. Bastani, Mohsen Kordjazi, Shahram Oveisgharan, Siamak Abdi
Introduction: Hereditary spastic paraplegia refers to a group of conditions characterized by a slow progression of spasticity in lower limbs resulting in gait abnormalities. Current treatment options have proven to be insufficient in terms of symptom alleviation. In this study, we tested the effectiveness of repetitive transcranial magnetic stimulation (rTMS) on lower limb spasticity in patients with
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Predictive Value of Multimodality Intraoperative Neurophysiological Monitoring During Cardiac Surgery J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Parthasarathy D. Thirumala, Akram I. Ahmad, Priya P. Roy, Jeffrey R. Balzer, Donald J. Crammond, Katherine M. Anetakis, Cara M. Fleseriu, Kathirvel Subramaniam, Ashutosh P. Jadhav, Arman Kilic, Thomas Gleason
Introduction: This study aimed to determine the ability of multimodality intraoperative neurophysiologic monitoring, including somatosensory evoked potentials (SSEP) and EEG, to predict perioperative clinical stroke and stroke-related mortality after open-heart surgery in high-risk patients. Methods: The records of all consecutive patients who underwent coronary artery bypass grafting, and cardiac
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How to Do an Electrophysiological Study of Myoclonus J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-02-01 Felipe Vial, Shabbir Hussain I. Merchant, Patrick McGurrin, Mark Hallett
Summary: Diagnosing and characterizing myoclonus can be challenging. Many authors agree on the need to complement the clinical findings with an electrophysiological study to characterize the movements. Besides helping to rule out other movements that may look like myoclonus, electrophysiology can help localize the source of the movement. This article aims to serve as a practical manual on how to do
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From Alpha to Zeta: A Systematic Review of Zeta Waves J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-01-01 Brin E. Freund, Tara Brigham, Saif Salman, Peter W. Kaplan, William O. IV Tatum
Purpose: Electroencephalogram is used for prognostication and diagnosis in critically ill patients and is vital in developing clinical management algorithms. Unique waveforms on EEG may distinguish neurological disorders and define a potential for seizures. To better characterize zeta waves, we sought to define their electroclinical spectrum. Methods: We performed a systematic review using MEDLINE
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A New Score for Sharp Discharges in the EEG Predicts Epilepsy J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-01-01 Eivind Aanestad, Nils E. Gilhus, Jan Brogger
Purpose: A challenge in EEG interpretation is to correctly classify suspicious focal sharp activity as epileptiform or not. A predictive score was developed from morphologic features of the first focal sharp discharge, which can help in this decision. Methods: From a clinical standard EEG database, the authors identified 2,063 patients without a previous epilepsy diagnosis who had a focal sharp discharge
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Stereo-EEG Evaluation and Surgical Treatment in Patients With Drug-Resistant Focal Epilepsy Associated With Nodular Heterotopia J. Clinical Neurophysiol. (IF 2.4) Pub Date : 2023-01-01 Sarah R. Durica, James P. Caruso, Irina Podkorytova, Kan Ding, Ryan Hays, Bradley Lega, Ghazala Perven
Purpose: Nodular heterotopia (NH) is a common cause of drug-resistant epilepsy. Only limited studies detail the treatment of NH with laser interstitial thermal therapy and none analyze the relation between epileptogenicity and NH location. Methods: We retrospectively studied nine patients with drug-resistant epilepsy and NH who underwent stereoelectroencephalography and subsequent epilepsy surgery