Clinical Neurophysiology Practice最新文献

英文中文

Electrodiagnostic criteria for neuromuscular transmission disorders suggested by a European consensus group

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.02.011

H. Tankisi , K. Pugdahl , B. Johnsen , J.P. Camdessanché , M. de Carvalho , P. Fawcett , A. Labarre-Vila , R. Liguori , W. Nix , I. Schofield , A. Fuglsang-Frederiksen

Objective

Electrodiagnostic testing plays an important role in diagnosing disorders of neuromuscular transmission (NMT), especially in seronegative myasthenia gravis. However, electrodiagnostic criteria for the diagnosis are sparse. This study aimed at inferring evidence-based recommendations for the electrodiagnostic examination of NMT disorders.

Methods

A total of 164 cases with a consensus diagnosis of NMT disorder obtained by peer review by eight experienced neurophysiologists were analysed for differences in examination strategy, the sensitivity of different tests, and inferring minimal criteria. The diagnostic performance of the suggested criteria was validated on 24 MG patients and 50 patients with neuropathy (17), myopathy (15), or fatigue (18).

Results

We recommend as minimal electrodiagnostic criteria for NMT disorders, either (a) 2 abnormal repetitive nerve stimulation (RNS), (b) 1 abnormal RNS and 1 abnormal single fiber electromyography (SFEMG) or (c) 2 abnormal SFEMG. These showed a good diagnostic performance with a sensitivity of 87.5 % and a specificity of 100 %.

Conclusion

Recommendations with high diagnostic sensitivity and specificity for the minimum number of RNS and SFEMG studies to diagnose NMT disorders developed by an international consensus group are suggested.

Significance

The suggested electrodiagnostic recommendations for diagnosing NMT disorders are reliable and suitable for use at different centres.

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引用次数: 0

A new method to evaluate staircase phenomenon in skeletal muscle using piezoelectric sensor 一种利用压电传感器评价骨骼肌阶梯现象的新方法。

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2024.12.002

Bungo Hirose , Tomihiro Imai , Kazuna Ikeda , Emiko Tsuda , Rika Yamauchi , Tatsuya Abe , Shin Hisahara

Objective

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.

Methods

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.

Results

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.

Conclusion

Staircase phenomenon abnormalities can be evaluated easily using piezoelectric sensors, indicating their potential utility for evaluating E-C coupling impairment in myopathies.

Significance

Piezoelectric sensors may be a useful tool to evaluate staircase phenomenon in skeletal muscle.

目的：楼梯现象是指随着肌肉的反复刺激收缩力的增加，这一现象已被研究多年，但方法难度大，应用不广泛。我们的目的是利用压电传感器来评估骨骼肌的阶梯现象。方法：选取35例无神经肌肉疾病（正常对照）、11例贝克肌营养不良症（BMD）和19例1型肌强直性营养不良症（MyD）患者作为研究对象。利用压电传感器记录正中神经重复刺激过程中复合肌肉动作电位（CMAP）和运动相关电位（MRP）波形，并测量其振幅和持续时间。根据CMAP和MRP发作潜伏期的差值计算兴奋-收缩耦合时间（ECCT）。结果：在正常对照中，MRP振幅比（相对于基线）随刺激持续时间的增加和刺激频率的增加而显著增加。然而，在BMD和MyD中，MRP振幅比随刺激时间的增加没有显著变化。特别是在MyD中，MRP振幅比没有随频率的增加而变化。结论：利用压电传感器可以很容易地评估楼梯现象异常，表明其在评估肌病E-C偶联损伤方面的潜在用途。意义：压电传感器可作为评估骨骼肌阶梯现象的有效工具。

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引用次数: 0

Longitudinal, EEG-based assessment of sleep in people with epilepsy: An automated sleep staging algorithm non-inferior to human raters

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.01.001

Asbjoern W. Helge , Federico G. Arguissain , Lukas Lechner , Gerhard Gritsch , Jonas Duun-Henriksen , Esben Ahrens , Tilmann Kluge , Manfred Hartmann

Objective

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.

Methods

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.

Results

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.

Conclusion

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.

Significance

This has the potential to make objective sleep parameters available in the clinic as a valuable addition to subjective sleep assessments.

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引用次数: 0

Intraoperative monitoring during awake craniotomy for glioblastoma resection in the second trimester of pregnancy. A case report and literature review

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.02.006

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

Objective

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.

Methods

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.

Results

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.

Conclusions

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.

Significance

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.

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引用次数: 0

Two-year experience of a newly established epilepsy monitoring unit in a resource-limited setting

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.02.012

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

Objective

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. Methods: 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. Results: 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. Conclusion: The implementation of a high-quality EMU is achievable in resource-limited settings. Significance: 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.

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引用次数: 0

Competence of healthcare professionals performing electroencephalography test: A systematic review

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.03.001

Elina Linnavuori , Irina Virtanen , Minna Stolt

Objective

To describe the EEG competence of healthcare professionals and how this competence has been measured in previous literature.

Methods

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.

Results

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.

Conclusion

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.

Significance

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.

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引用次数: 0

Within five weeks: Rapidly grown glioblastoma discovered on repeat MRI after pathologic EEG

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.02.002

Zsuzsanna Szankai , Egle Huggenberger , Christoph Metzler , Christian Musahl , Markus Gschwind

Background

According to the recommendations of the International League against Epilepsy, a timely workup with a brain MRI is recommended after a first epileptic seizure. However, if the MRI is unrevealing, it is normally not repeated.

Case Presentation

We present a patient with an unprovoked epileptic seizure and only slight focal abnormalities in the EEG and a normal brain MRI. Only 35 days later, after a third seizure and now a focally pathological EEG, we repeated the brain MRI and discovered a large mass in the left temporal lobe, which was resected and histologically classified as glioblastoma multiforme.

Conclusion

This case of a very fast-growing tumor suggests that recurrent seizures, with or without anti-seizure medications, or new changes in the EEG should prompt the clinician to consider a repeat brain MRI, even if the first scan was normal.

引用次数: 0

Corrigendum to “Neurophysiological monitoring during anterior cervical discectomy and fusion for ossification of the posterior longitudinal ligament” [Clin. Neurophysiol. Pract. 6 (2021) 56–62]

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.02.001

Jee-Eun Kim , Jun-Soon Kim , Sejin Yang , Jongsuk Choi , Seung-Jae Hyun , Ki-Jeong Kim , Kyung Seok Park

引用次数: 0

The role of EEG in the emergency department: Its contribution to the patient’s diagnostic–therapeutic pathway. The EMINENCE study

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2025.02.010

Scarpino Maenia , Verna Maria Teresa , Grippo Antonello , Lolli Francesco , Piccardi Benedetta , Nazerian Peiman , Nencini Patrizia , Boccardi Cristina , Nencioni Andrea

Objectives

To investigate the utility of the emergency electroencephalogram(emEEG) in the diagnostic work-up of patients admitted to the Emergency Department(ED).

Methods

Data from consecutive patients admitted to the ED during a 1-year period. We evaluated the usefulness of emEEGs based on the subsequent patient clinical management.

Results

1125 emEEGs from 1018 patients were analyzed. The overall usefulness of an emEEG was 86.7%, mainly influenced by its contribution to diagnosis(75.0%), often excluding initial working diagnosis(50.0%), and to patient management(78.0%). EmEEGs showed their best overall usefulness in Status Epilepticus(SE) and altered level of consciousness both in contributing to the final diagnosis and in patient management and therapeutic pathway. In speech and cognitive/behavioural disorders, emEEGs contributed to the diagnosis(80.6% and 79.8%, respectively), often excluding the initial suspicion of seizures/SE. Normal emEEGs contributed to diagnosis(79.0%), patient management(87.0%) and discharge to home(82.0%).

Conclusions

In ED, attending physicians have to make quick decisions about the diagnostic–therapeutic management of patients, and also the ruling out of the initial diagnosis and safely discharging the patient to home are also important goals.

Significance

This study provides valuable guidance to ED clinicians in selecting patients for an emEEG and evaluates its contribution to their diagnostic–therapeutic management.

{"title":"The role of EEG in the emergency department: Its contribution to the patient’s diagnostic–therapeutic pathway. The EMINENCE study","authors":"Scarpino Maenia , Verna Maria Teresa , Grippo Antonello , Lolli Francesco , Piccardi Benedetta , Nazerian Peiman , Nencini Patrizia , Boccardi Cristina , Nencioni Andrea","doi":"10.1016/j.cnp.2025.02.010","DOIUrl":"10.1016/j.cnp.2025.02.010","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the utility of the emergency electroencephalogram(emEEG) in the diagnostic work-up of patients admitted to the Emergency Department(ED).</div></div><div><h3>Methods</h3><div>Data from consecutive patients admitted to the ED during a 1-year period. We evaluated the usefulness of emEEGs based on the subsequent patient clinical management.</div></div><div><h3>Results</h3><div>1125 emEEGs from 1018 patients were analyzed. The overall usefulness of an emEEG was 86.7%, mainly influenced by its contribution to diagnosis(75.0%), often excluding initial working diagnosis(50.0%), and to patient management(78.0%). EmEEGs showed their best overall usefulness in Status Epilepticus(SE) and altered level of consciousness both in contributing to the final diagnosis and in patient management and therapeutic pathway. In speech and cognitive/behavioural disorders, emEEGs contributed to the diagnosis(80.6% and 79.8%, respectively), often excluding the initial suspicion of seizures/SE. Normal emEEGs contributed to diagnosis(79.0%), patient management(87.0%) and discharge to home(82.0%).</div></div><div><h3>Conclusions</h3><div>In ED, attending physicians have to make quick decisions about the diagnostic–therapeutic management of patients, and also the ruling out of the initial diagnosis and safely discharging the patient to home are also important goals.</div></div><div><h3>Significance</h3><div>This study provides valuable guidance to ED clinicians in selecting patients for an emEEG and evaluates its contribution to their diagnostic–therapeutic management.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 70-77"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580355","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}

引用次数: 0

Averted weakness from a large Martin-Gruber anastomosis 避免了马丁-格鲁伯吻合术造成的虚弱。

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice

Pub Date : 2025-01-01 DOI: 10.1016/j.cnp.2024.12.003

Emily Cheung, Karl Ng

引用次数: 0

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全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

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