Pub Date : 2025-01-01Epub Date: 2025-02-28DOI: 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.
{"title":"Intraoperative monitoring during awake craniotomy for glioblastoma resection in the second trimester of pregnancy. A case report and literature review","authors":"Bayron A. Sandoval-Bonilla , Isela Valverde Luna , Aleida Arritola-Uriarte , Daniel San-Juan , Ricardo García-Iturbide , Alma Edith Gress Mendoza , Lorely Cumplido Pulido , Lizzette Hinojosa González , Alfredo Lara Bahena , Maria F. De la Cerda Vargas","doi":"10.1016/j.cnp.2025.02.006","DOIUrl":"10.1016/j.cnp.2025.02.006","url":null,"abstract":"<div><h3>Objective</h3><div>To demonstrate the feasibility and safety of awake craniotomy (AC) with intraoperative neurophysiological monitoring (IONM) for glioblastoma (GB) resection in a pregnant patient, ensuring preservation of neurological functions and fetal well-being.</div></div><div><h3>Methods</h3><div>A 27-year-old gravida 2, para 1 woman presented at 19.4 weeks of pregnancy with severe headaches and a generalized tonic-clonic seizure. Imaging confirmed a malignant glioma, and an interdisciplinary team opted for AC with IONM to achieve maximal tumor resection while minimizing maternal and fetal risks.</div></div><div><h3>Results</h3><div>Surgery was performed during the second trimester with successful gross total resection of the tumor. IONM strategies preserved neurological function, and fetal well-being was maintained. Postoperative evaluations showed no complications, and the patient was discharged in improved condition.</div></div><div><h3>Conclusions</h3><div>AC with IONM is a viable and safe surgical approach for GB resection during pregnancy. Tailoring the surgical plan by considering gestational age, maternal health, and fetal safety is crucial.</div></div><div><h3>Significance</h3><div>This case highlights the importance of multidisciplinary management in optimizing outcomes for pregnant patients with GB, contributing valuable insights to the limited literature on neurosurgical interventions during pregnancy.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 63-69"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"A new method to evaluate staircase phenomenon in skeletal muscle using piezoelectric sensor","authors":"Bungo Hirose , Tomihiro Imai , Kazuna Ikeda , Emiko Tsuda , Rika Yamauchi , Tatsuya Abe , Shin Hisahara","doi":"10.1016/j.cnp.2024.12.002","DOIUrl":"10.1016/j.cnp.2024.12.002","url":null,"abstract":"<div><h3>Objective</h3><div>The staircase phenomenon, which refers to the increases in the force of contraction with repetitive stimulation of the muscle, has been studied for many years, but the method is difficult and not widely used. Our objective was to evaluate the staircase phenomenon in skeletal muscle using a piezoelectric sensor.</div></div><div><h3>Methods</h3><div>Thirty-five subjects without neuromuscular diseases (normal controls), 11 patients with Becker muscular dystrophy (BMD), and 19 patients with myotonic dystrophy type 1 (MyD) were studied. Compound muscle action potential (CMAP) and movement-related potential (MRP) waveforms were recorded using piezoelectric sensors during repetitive stimulation of the median nerve, and the amplitudes and durations were measured. Excitation-contraction (E-C) coupling time (ECCT) was calculated from the difference between onset latencies of CMAP and MRP.</div></div><div><h3>Results</h3><div>In normal controls, MRP amplitude ratio (relative to baseline) increased significantly with increase in stimulation duration and with increase in stimulation frequency. In BMD and MyD, however, MRP amplitude ratio did not change significantly with increase in stimulation duration. Especially, in MyD, there was no change in MRP amplitude ratio with increase in frequency.</div></div><div><h3>Conclusion</h3><div>Staircase phenomenon abnormalities can be evaluated easily using piezoelectric sensors, indicating their potential utility for evaluating E-C coupling impairment in myopathies.</div></div><div><h3>Significance</h3><div>Piezoelectric sensors may be a useful tool to evaluate staircase phenomenon in skeletal muscle.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 1-9"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-09-11DOI: 10.1016/j.cnp.2025.09.001
Laurent Sheybani , Pia De Stefano , Margitta Seeck , Serge Vulliémoz , Pierre Mégevand
Focal slowing in scalp electroencephalography (EEG) is classically seen as an unspecific entity in terms of its association with both epilepsy and distinct aetiologies. This could be due to a lack of standardization in the assessment of slowing morphology, in distinction to precise guidelines utilized in the evaluation of pathological activities, such as interictal epileptiform discharges (IEDs). However, consistent features can be identified, which can be informative about the underlying brain pathology and risk of seizures. In this review, we discuss the different kinds of focal slowing, focusing mainly on the delta range (0.5–4 Hz), their respective pathological processes and their prognostic value in terms of likelihood to be associated with acute seizures or epilepsy. We then present new findings on source localization of focal slowing. Last, we review recent evidence of interaction between focal slow activities and epileptic activities. Our didactic approach will guide readers through important aspects of an EEG entity that might have been neglected despite past and recent observations of its relevance in epilepsy.
{"title":"EEG focal delta slowing in focal epilepsy – A didactic review","authors":"Laurent Sheybani , Pia De Stefano , Margitta Seeck , Serge Vulliémoz , Pierre Mégevand","doi":"10.1016/j.cnp.2025.09.001","DOIUrl":"10.1016/j.cnp.2025.09.001","url":null,"abstract":"<div><div>Focal slowing in scalp electroencephalography (EEG) is classically seen as an unspecific entity in terms of its association with both epilepsy and distinct aetiologies. This could be due to a lack of standardization in the assessment of slowing morphology, in distinction to precise guidelines utilized in the evaluation of pathological activities, such as interictal epileptiform discharges (IEDs). However, consistent features can be identified, which can be informative about the underlying brain pathology and risk of seizures. In this review, we discuss the different kinds of focal slowing, focusing mainly on the delta range (0.5–4 Hz), their respective pathological processes and their prognostic value in terms of likelihood to be associated with acute seizures or epilepsy. We then present new findings on source localization of focal slowing. Last, we review recent evidence of interaction between focal slow activities and epileptic activities. Our didactic approach will guide readers through important aspects of an EEG entity that might have been neglected despite past and recent observations of its relevance in epilepsy.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 392-401"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-01-27DOI: 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.
{"title":"Longitudinal, EEG-based assessment of sleep in people with epilepsy: An automated sleep staging algorithm non-inferior to human raters","authors":"Asbjoern W. Helge , Federico G. Arguissain , Lukas Lechner , Gerhard Gritsch , Jonas Duun-Henriksen , Esben Ahrens , Tilmann Kluge , Manfred Hartmann","doi":"10.1016/j.cnp.2025.01.001","DOIUrl":"10.1016/j.cnp.2025.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>There is an unmet need in epilepsy management for tools that measure sleep objectively over long timespans. Subcutaneous EEG is well-suited for the task, but it requires a reliable automatic algorithm. Here, we present and evaluate such an algorithm, and we show clinical examples of how it produces important information.</div></div><div><h3>Methods</h3><div>A mix of scalp EEG and subcutaneous EEG was used to develop an algorithm to output sleep stages and common sleep parameters. The algorithm was tested on unseen data from 11 healthy subject and 12 people with epilepsy (PwE). Lastly, data (>3months) from three exemplary PwE were analyzed for sleep.</div></div><div><h3>Results</h3><div>The algorithm proved non-inferior at sleep stage segmentation on data from PwE compared to human raters using scalp EEG. It reached a Cohen’s kappa score of 0.8 [CI 0.78 – 0.83] on healthy subjects and on data from PwE it got to 0.705 [CI 0.663–––0.744] against rater D and 0.686 [CI 0.632–––0.739] against rater E. The three examples showed that useful information can be gained from longitudinal sleep analysis.</div></div><div><h3>Conclusion</h3><div>Subcutaneous EEG and a sleep algorithm can be employed to effectively review sleep in PwE at a level that is non-inferior compared to human raters.</div></div><div><h3>Significance</h3><div>This has the potential to make objective sleep parameters available in the clinic as a valuable addition to subjective sleep assessments.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 30-39"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143175361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-03-08DOI: 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.
目的描述卫生保健专业人员的脑电图能力，以及在以往文献中如何测量这种能力。方法根据系统评价和元分析的首选报告项目进行系统评价。在CINAHL、PubMed、Scopus和Web of Science数据库中进行了文献检索，重点研究了医疗保健专业人员脑电图能力的实证研究。结果共纳入28项研究。脑电能力包括两大类：脑电知识和技能，以及对脑电的态度和价值观。在三种不同的环境中评估医疗保健专业人员的脑电图能力：测试、模拟和现实生活。资料收集方法为知识测验、自我评估和观察。这些工具是由研究人员为单个研究开发的，没有进行心理测量学测试。结论脑电能力是一个多维的概念，包括知识、技能、态度和价值观，在定义脑电能力和开发测量工具时需要考虑这些因素。本系统综述为参与制定全面脑电图培训计划和评估的医疗保健专业人员和医疗保健组织的教育者提供了信息，以促进专业发展并确保患者的诊断测试结果可靠。
{"title":"Competence of healthcare professionals performing electroencephalography test: A systematic review","authors":"Elina Linnavuori , Irina Virtanen , Minna Stolt","doi":"10.1016/j.cnp.2025.03.001","DOIUrl":"10.1016/j.cnp.2025.03.001","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the EEG competence of healthcare professionals and how this competence has been measured in previous literature.</div></div><div><h3>Methods</h3><div>A systematic review following the preferred Reporting Items for Systematic Reviews and Meta-Analyses. A literature search was conducted in CINAHL, PubMed, Scopus, and Web of Science databases focusing on studies that empirically examined the EEG competence of healthcare professionals.</div></div><div><h3>Results</h3><div>A total of 28 studies were included. EEG competence consists of two main categories: knowledge and skills of EEG, and attitudes and values towards EEG. The EEG competence of healthcare professionals was assessed in three different settings: tests, simulations, and real life. The data collection methods were knowledge tests, self-assessments, and observations. The tools were developed by a researcher(s) for the single study and were not psychometrically tested.</div></div><div><h3>Conclusion</h3><div>EEG competence is a multidimensional concept that includes knowledge, skills, attitudes, and values that need to be considered when defining EEG competence and developing tools to measure it.</div></div><div><h3>Significance</h3><div>This systematic review provides information to the educators of healthcare professionals and healthcare organizations involved in developing comprehensive EEG training programs and assessments to foster professional development and ensure reliable diagnostic test results for patients.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 104-115"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01Epub Date: 2025-10-17DOI: 10.1016/j.cnp.2025.10.003
Vera Flasbeck , Andreas Ebert , Bettina Klostermann , Daniel Richter , Ralf Gold , Christos Krogias , Georg Juckel
Objective
Acute ischemic stroke (AIS) is often accompanied by functional impairments and post-stroke depression (PSD), affecting ∼30 % of patients. Since central serotonergic dysfunction may contribute to PSD, similar to major depressive disorder, we examined depressive symptoms and serotonergic neurotransmission after AIS using the loudness dependence of auditory evoked potentials (LDAEP), a non-invasive EEG marker.
Methods
19 patients with AIS and 18 age-matched healthy participants completed depression questionnaires (BDI, HAMD). LDAEP was assessed within 14 days after AIS and after three months, analyzed with mixed-models ANOVA.
Results
Shortly after AIS, patients showed lower LDAEP compared to controls for all electrodes (AIS M = 0.072 ± 0.077; controls M = 0.133 ± 0.095; p = 0.037), frontal (p = 0.011) and frontocentral (p = 0.027) electrodes. After three months, differences reached trend-level (p = 0.12). Depression scores were higher in patients, but not clinically relevant.
Conclusions
AIS appears to be associated with altered serotonergic neurotransmission, with attenuated LDAEP differences at three months possibly reflecting remission. As depression scores were not clinically relevant, serotonergic changes likely reflect a general AIS effect rather than being specific to PSD.
Significance
Early LDAEP measurement may serve as a non-invasive biomarker to identify patients with altered serotonergic functioning and guide interventions, such as SSRI therapy, to reduce PSD risk and improve recovery.
{"title":"Increased central serotonergic activity in patients after an acute ischemic stroke. An EEG study","authors":"Vera Flasbeck , Andreas Ebert , Bettina Klostermann , Daniel Richter , Ralf Gold , Christos Krogias , Georg Juckel","doi":"10.1016/j.cnp.2025.10.003","DOIUrl":"10.1016/j.cnp.2025.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>Acute ischemic stroke (AIS) is often accompanied by functional impairments and post-stroke depression (PSD), affecting ∼30 % of patients. Since central serotonergic dysfunction may contribute to PSD, similar to major depressive disorder, we examined depressive symptoms and serotonergic neurotransmission after AIS using the loudness dependence of auditory evoked potentials (LDAEP), a non-invasive EEG marker.</div></div><div><h3>Methods</h3><div>19 patients with AIS and 18 age-matched healthy participants completed depression questionnaires (BDI, HAMD). LDAEP was assessed within 14 days after AIS and after three months, analyzed with mixed-models ANOVA.</div></div><div><h3>Results</h3><div>Shortly after AIS, patients showed lower LDAEP compared to controls for all electrodes (AIS <em>M</em> = 0.072 ± 0.077; controls <em>M</em> = 0.133 ± 0.095; <em>p</em> = 0.037), frontal (<em>p</em> = 0.011) and frontocentral (<em>p</em> = 0.027) electrodes. After three months, differences reached trend-level (<em>p</em> = 0.12). Depression scores were higher in patients, but not clinically relevant.</div></div><div><h3>Conclusions</h3><div>AIS appears to be associated with altered serotonergic neurotransmission, with attenuated LDAEP differences at three months possibly reflecting remission. As depression scores were not clinically relevant, serotonergic changes likely reflect a general AIS effect rather than being specific to PSD.</div></div><div><h3>Significance</h3><div>Early LDAEP measurement may serve as a non-invasive biomarker to identify patients with altered serotonergic functioning and guide interventions, such as SSRI therapy, to reduce PSD risk and improve recovery.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 480-486"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145319534","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}
Pub Date : 2025-01-01Epub Date: 2025-02-21DOI: 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
{"title":"Corrigendum to “Neurophysiological monitoring during anterior cervical discectomy and fusion for ossification of the posterior longitudinal ligament” [Clin. Neurophysiol. Pract. 6 (2021) 56–62]","authors":"Jee-Eun Kim , Jun-Soon Kim , Sejin Yang , Jongsuk Choi , Seung-Jae Hyun , Ki-Jeong Kim , Kyung Seok Park","doi":"10.1016/j.cnp.2025.02.001","DOIUrl":"10.1016/j.cnp.2025.02.001","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Page 78"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580360","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}
Pub Date : 2025-01-01Epub Date: 2025-03-03DOI: 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}
Pub Date : 2025-01-01Epub Date: 2025-07-09DOI: 10.1016/j.cnp.2025.07.002
Michael N. Dretsch , Katie M. Williams , Diana P. Evans , Katrina S. Monti , Brian J. Guise , Mark L. Ettenhofer , Jamie N. Hershaw
Objectives
This study aimed to assess the contribution of demographics, medical history, and psychological health to pupillary light reflex (PLR) indices in Service members with and without a history of mild traumatic brain injury (mTBI).
Methods
PLR data from NeurOptics NPi-300 were analyzed on 216 participants who were categorized as non-injured controls (NIC), mTBI with no loss of consciousness (mTBILOC-), or mTBI with LOC (mTBILOC+). Multiple independent regression models were conducted for each PLR index to assess the contribution of these factors to the variability of PLR indices by group.
Results
There were no significant group differences on the PLR indices. Age was a significant factor across groups, but more robust for those with mTBI. Sleep duration, injury characteristics, and psychological health effects on PLR indices were primarily observed in the mTBILOC+ group. Posttraumatic stress and sex were not significant predictors in any of the models.
Conclusions
When using PLR for screening of mTBI, an individual’s age, history of prior mTBI, total lifetime TBI-related alterations in consciousness, sleep, and anxiety and depression symptoms should be considered when interpreting PLR metrics.
Significance
Controlling for these factors is essential for validating the use of PLR for screening of mTBI.
{"title":"Multiple factors contribute to pupillary light reflex: implications for screening of traumatic brain injury in military service members","authors":"Michael N. Dretsch , Katie M. Williams , Diana P. Evans , Katrina S. Monti , Brian J. Guise , Mark L. Ettenhofer , Jamie N. Hershaw","doi":"10.1016/j.cnp.2025.07.002","DOIUrl":"10.1016/j.cnp.2025.07.002","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to assess the contribution of demographics, medical history, and psychological health to pupillary light reflex (PLR) indices in Service members with and without a history of mild traumatic brain injury (mTBI).</div></div><div><h3>Methods</h3><div>PLR data from NeurOptics NPi-300 were analyzed on 216 participants who were categorized as non-injured controls (NIC), mTBI with no loss of consciousness (mTBI<sup>LOC-</sup>), or mTBI with LOC (mTBI<sup>LOC+</sup>). Multiple independent regression models were conducted for each PLR index to assess the contribution of these factors to the variability of PLR indices by group.</div></div><div><h3>Results</h3><div>There were no significant group differences on the PLR indices. Age was a significant factor across groups, but more robust for those with mTBI. Sleep duration, injury characteristics, and psychological health effects on PLR indices were primarily observed in the mTBI<sup>LOC+</sup> group. Posttraumatic stress and sex were not significant predictors in any of the models.</div></div><div><h3>Conclusions</h3><div>When using PLR for screening of mTBI, an individual’s age, history of prior mTBI, total lifetime TBI-related alterations in consciousness, sleep, and anxiety and depression symptoms should be considered when interpreting PLR metrics.</div></div><div><h3>Significance</h3><div>Controlling for these factors is essential for validating the use of PLR for screening of mTBI.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 256-264"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605723","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}
Pub Date : 2025-01-01Epub Date: 2025-02-22DOI: 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.
{"title":"Within five weeks: Rapidly grown glioblastoma discovered on repeat MRI after pathologic EEG","authors":"Zsuzsanna Szankai , Egle Huggenberger , Christoph Metzler , Christian Musahl , Markus Gschwind","doi":"10.1016/j.cnp.2025.02.002","DOIUrl":"10.1016/j.cnp.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Case Presentation</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 52-55"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143509100","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}
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