Pub Date : 2025-01-01DOI: 10.1016/j.cnp.2025.06.008
Abhimanyu Mahajan , Alberto Jaramillo-Jimenez , Anita D’Anselmo , Giulia Prete , Lucrezia Bristot , Sara Varanese , Alberto Di Domenico , Nicola Mammarella , Luca Tommasi , Michele Tinazzi , Dag Aarsland , Claudio Babiloni , Alberto J. Espay , Laura Bonanni
The spectral analysis of the resting-state eyes-closed electroencephalographic (rsEEG) activity typically shows abnormal delta (< 4 Hz), theta (4–7 Hz), and alpha (8–12 Hz) power in older patients with cognitive deficits due to progressive neurodegenerative diseases. Interestingly, abnormally prominent posterior rsEEG power < 8 Hz with periodic fluctuations in the pre-alpha/theta range has been considered a supportive biomarker for diagnosing patients with prodromal or manifest dementia due to Lewy bodies (DLB) in international guidelines. Here, a panel of experts shortly reviews the concepts of thalamocortical dysrhythmia as a possible neurophysiological oscillatory mechanism generating those rsEEG abnormalities in DLB patients. It also recommends how to record and quantitatively analyze rsEEG activity in prodromal and manifesting DLB patients for the application of that cost-effective and largely available diagnostic procedure in clinical practice.
{"title":"Quantitative electroencephalography in the diagnosis of dementia with Lewy bodies","authors":"Abhimanyu Mahajan , Alberto Jaramillo-Jimenez , Anita D’Anselmo , Giulia Prete , Lucrezia Bristot , Sara Varanese , Alberto Di Domenico , Nicola Mammarella , Luca Tommasi , Michele Tinazzi , Dag Aarsland , Claudio Babiloni , Alberto J. Espay , Laura Bonanni","doi":"10.1016/j.cnp.2025.06.008","DOIUrl":"10.1016/j.cnp.2025.06.008","url":null,"abstract":"<div><div>The spectral analysis of the resting-state eyes-closed electroencephalographic (rsEEG) activity typically shows abnormal delta (< 4 Hz), theta (4–7 Hz), and alpha (8–12 Hz) power in older patients with cognitive deficits due to progressive neurodegenerative diseases. Interestingly, abnormally prominent posterior rsEEG power < 8 Hz with periodic fluctuations in the pre-alpha/theta range has been considered a supportive biomarker for diagnosing patients with prodromal or manifest dementia due to Lewy bodies (DLB) in international guidelines. Here, a panel of experts shortly reviews the concepts of thalamocortical dysrhythmia as a possible neurophysiological oscillatory mechanism generating those rsEEG abnormalities in DLB patients. It also recommends how to record and quantitatively analyze rsEEG activity in prodromal and manifesting DLB patients for the application of that cost-effective and largely available diagnostic procedure in clinical practice.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 222-233"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548595","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 : 2025-01-01DOI: 10.1016/j.cnp.2025.07.006
Masud Seyal, Todd Chatlos, George Savvides, Shari Barela
Objective
There is evidence for a pre-ictal state, distinct from the interictal state, that can be detected minutes before the onset of a clinical seizure. Analysis of scalp EEG signals do not reliably distinguish the pre-ictal EEG from the interictal EEG. Changes in cerebral blood flow and oxygenation occur several minutes before EEG evidence of a seizure. Local increases in cerebral activity are associated with increases in brain temperature. Brain temperature changes are reflected in the tympanic membrane temperature. This exploratory study investigated whether a brain temperature change could be detected noninvasively in the immediate pre-ictal period.
Methods
Patients with focal seizures undergoing inpatient video-EEG telemetry had epitympanic temperatures recorded. Pre-ictal temperature changes deviating from the interictal temperature were studied.
Results
Data was available for 25 seizures in 12 patients. For a given seizure, the mean temperature at seizure onset exceeded the interictal temperature by 0.31 °C. Peri-ictal peak temperature exceeded the interictal temperature by a mean of 0.37 °C. Duration of temperature rise was 1081 s.
Conclusions
Pre-ictal temperature increases were detected non-invasively in focal onset seizures.
Significance
This finding provides the basis for development of temperature-based technology for seizure warning in ambulatory patients with refractory epilepsy.
{"title":"Pre-ictal temperature increases detected by ear canal thermometry in the epilepsy monitoring unit. An exploratory study","authors":"Masud Seyal, Todd Chatlos, George Savvides, Shari Barela","doi":"10.1016/j.cnp.2025.07.006","DOIUrl":"10.1016/j.cnp.2025.07.006","url":null,"abstract":"<div><h3>Objective</h3><div>There is evidence for a pre-ictal state, distinct from the interictal state, that can be detected minutes before the onset of a clinical seizure. Analysis of scalp EEG signals do not reliably distinguish the pre-ictal EEG from the interictal EEG. Changes in cerebral blood flow and oxygenation occur several minutes before EEG evidence of a seizure. Local increases in cerebral activity are associated with increases in brain temperature. Brain temperature changes are reflected in the tympanic membrane temperature. This exploratory study investigated whether a brain temperature change could be detected noninvasively in the immediate pre-ictal period.</div></div><div><h3>Methods</h3><div>Patients with focal seizures undergoing inpatient video-EEG telemetry had epitympanic temperatures recorded. Pre-ictal temperature changes deviating from the interictal temperature were studied.</div></div><div><h3>Results</h3><div>Data was available for 25 seizures in 12 patients. For a given seizure, the mean temperature at seizure onset exceeded the interictal temperature by 0.31 °C. Peri-ictal peak temperature exceeded the interictal temperature by a mean of 0.37 °C. Duration of temperature rise was 1081 s.</div></div><div><h3>Conclusions</h3><div>Pre-ictal temperature increases were detected non-invasively in focal onset seizures.</div></div><div><h3>Significance</h3><div>This finding provides the basis for development of temperature-based technology for seizure warning in ambulatory patients with refractory epilepsy.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 340-345"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144779855","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 : 2025-01-01DOI: 10.1016/j.cnp.2025.09.003
Christian Sandøe Musaeus , Pedro F. Viana , Mark Cook , Jonas Duun-Henriksen , Sándor Beniczky , Preben Kidmose , Bart Vanrumste , Benjamin Filtjens , Troels Wesenberg Kjaer
Background
Home-based neurophysiological monitoring is improving the assessment and management of neurological conditions such as epilepsy. Technologies such as electroencephalography (EEG), electromyography (EMG), and accelerometry are increasingly integrated into wearable systems for at-home use. Due to an increasing amount of data from long-term monitoring, machine learning algorithms assist in automated data analysis. However, ensuring device accuracy, signal quality, and user compliance remains crucial for clinical useability.
Objective
This chapter explores advances and challenges in at-home neurophysiological monitoring, with a primary focus on EEG systems and their applications.
Content: The discussion highlights the technological advances and the challenges associated with at-home monitoring. The focus will be on EEG systems, as well as a discussion of EMG in epilepsy. Next, we will provide an overview of the clinical applications for home-based monitoring of epilepsy and sleep disorders. Lastly, we will briefly discuss emerging topics within home-based monitoring in movement disorders and neurodegenerative disorders.
Conclusion
Future advancements are expected with new generations of wearable systems capable of providing long-term monitoring with minimal maintenance. Beyond epilepsy and sleep disorders, home-based technologies are also being investigated in other neurological diseases including movement disorders and neurodegenerative diseases showing the expanding scope of home-based technologies in neurology.
{"title":"Home-Based sensing of the nervous system with clinical neurophysiology technologies: IFCN handbook chapter","authors":"Christian Sandøe Musaeus , Pedro F. Viana , Mark Cook , Jonas Duun-Henriksen , Sándor Beniczky , Preben Kidmose , Bart Vanrumste , Benjamin Filtjens , Troels Wesenberg Kjaer","doi":"10.1016/j.cnp.2025.09.003","DOIUrl":"10.1016/j.cnp.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Home-based neurophysiological monitoring is improving the assessment and management of neurological conditions such as epilepsy. Technologies such as electroencephalography (EEG), electromyography (EMG), and accelerometry are increasingly integrated into wearable systems for at-home use. Due to an increasing amount of data from long-term monitoring, machine learning algorithms assist in automated data analysis. However, ensuring device accuracy, signal quality, and user compliance remains crucial for clinical useability.</div></div><div><h3>Objective</h3><div>This chapter explores advances and challenges in at-home neurophysiological monitoring, with a primary focus on EEG systems and their applications.</div><div>Content: The discussion highlights the technological advances and the challenges associated with at-home monitoring. The focus will be on EEG systems, as well as a discussion of EMG in epilepsy. Next, we will provide an overview of the clinical applications for home-based monitoring of epilepsy and sleep disorders. Lastly, we will briefly discuss emerging topics within home-based monitoring in movement disorders and neurodegenerative disorders.</div></div><div><h3>Conclusion</h3><div>Future advancements are expected with new generations of wearable systems capable of providing long-term monitoring with minimal maintenance. Beyond epilepsy and sleep disorders, home-based technologies are also being investigated in other neurological diseases including movement disorders and neurodegenerative diseases showing the expanding scope of home-based technologies in neurology.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 453-463"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145264827","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 : 2025-01-01DOI: 10.1016/j.cnp.2025.08.002
Michael H. Goodman , Paul Hwang , Carole D. Burnham , Solomon L. Moshé , Jeremy M. Barry , Gregory L. Holmes
Objective/methods
The Eastern Association of Electroencephalographers (EAEEG), founded in 1946, is recognized as the world’s oldest EEG society. This review traces its history, highlighting contributions from notable members and the significance of the Kirshman and Milner lectureships in advancing the field.
Results
Although established in Hartford, Connecticut, the society’s intellectual roots lie at the Montreal Neurological Institute, home to pioneering EEG researchers Wilder Penfield and Herbert Jasper. Over more than seven decades, the EAEEG has played a pivotal role in fostering research, education, and collaboration across the United States and Canada. Its conferences have featured distinguished keynote lectures, including presentations by three Nobel Laureates, emphasizing the society’s prominence in neurophysiological advancements. The society has successfully facilitated transnational collaboration, offering a platform for both trainees and experienced clinicians and scientists to exchange knowledge and promote progress in clinical and basic neurophysiology.
Conclusions/Significance
Despite the prominence of large international conferences, the EAEEG’s influence underscores the importance of smaller, multinational societies in shaping neurophysiological research and practice. Its history exemplifies how collaborative efforts between the US and Canada can drive scientific innovation and education within a supportive, collegial environment, reinforcing the enduring impact of specialized professional societies on the field.
{"title":"The Eastern Association of Electroencephalographers: A Canadian/USA success story","authors":"Michael H. Goodman , Paul Hwang , Carole D. Burnham , Solomon L. Moshé , Jeremy M. Barry , Gregory L. Holmes","doi":"10.1016/j.cnp.2025.08.002","DOIUrl":"10.1016/j.cnp.2025.08.002","url":null,"abstract":"<div><h3>Objective/methods</h3><div>The Eastern Association of Electroencephalographers (EAEEG), founded in 1946, is recognized as the world’s oldest EEG society. This review traces its history, highlighting contributions from notable members and the significance of the Kirshman and Milner lectureships in advancing the field.</div></div><div><h3>Results</h3><div>Although established in Hartford, Connecticut, the society’s intellectual roots lie at the Montreal Neurological Institute, home to pioneering EEG researchers Wilder Penfield and Herbert Jasper. Over more than seven decades, the EAEEG has played a pivotal role in fostering research, education, and collaboration across the United States and Canada. Its conferences have featured distinguished keynote lectures, including presentations by three Nobel Laureates, emphasizing the society’s prominence in neurophysiological advancements. The society has successfully facilitated transnational collaboration, offering a platform for both trainees and experienced clinicians and scientists to exchange knowledge and promote progress in clinical and basic neurophysiology.</div></div><div><h3>Conclusions/Significance</h3><div>Despite the prominence of large international conferences, the EAEEG’s influence underscores the importance of smaller, multinational societies in shaping neurophysiological research and practice. Its history exemplifies how collaborative efforts between the US and Canada can drive scientific innovation and education within a supportive, collegial environment, reinforcing the enduring impact of specialized professional societies on the field.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 404-425"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145158044","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 : 2025-01-01DOI: 10.1016/j.cnp.2025.08.005
Hosna Elshony , Mohamed H. Aly , Abdelgaffar Mohammed , Abdulrahman M. Hassan , Abdulrahman A. Alshehri , Mohamed Hedak , Rakan Almuhanna , Abdulaziz Al-Ghamdi , Rasha Elsaadawy
{"title":"Asymptomatic tarsal tunnel syndrome in rheumatoid Arthritis: An electrophysiological perspective with insights into clinical and laboratory correlates","authors":"Hosna Elshony , Mohamed H. Aly , Abdelgaffar Mohammed , Abdulrahman M. Hassan , Abdulrahman A. Alshehri , Mohamed Hedak , Rakan Almuhanna , Abdulaziz Al-Ghamdi , Rasha Elsaadawy","doi":"10.1016/j.cnp.2025.08.005","DOIUrl":"10.1016/j.cnp.2025.08.005","url":null,"abstract":"","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 348-349"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004016","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}
Decrement responses in repetitive nerve stimulation (RNS) are theoretically expected to correlate with the disease progression speed in amyotrophic lateral sclerosis (ALS). However, actual results have been controversial. We investigated this issue using ΔFS calculated from the ALS functional rating scale revised version (ALSFRS-R) and the duration of illness.
Methods
RNS results of the abductor pollicis brevis, trapezius, and deltoid muscles in our previous study were reviewed. We investigated correlations and multiple regressions regarding decremental percentage (Decr%), the amplitude of the initial compound muscle action potential (Amp), and progression speed parameters, i.e. ΔFS or ΔUL-FS, the latter being the ΔFS for the upper-limb questions in ALSFRS-R.
Results
Included subjects were 124 patients with ALS, 47 of whom were upper-limb onset. Multiple regression analyses revealed that Decr% is largely determined by Amp and that Δ FS or ΔUL-FS showed no or little contributions to Decr%.
Conclusions
Decremental responses in RNS does not predict the speed of progression of the functional impairment in patients with ALS.
Significance
This study suggests that the decremental responses in RNS in ALS are contributed by the impaired neuromuscular transmission in chronic sprouts following extensive reinnervation, as well as by the immature sprouts.
{"title":"Correlation between decremental responses in repetitive nerve stimulation and disease progression rate in patients with amyotrophic lateral sclerosis","authors":"Yuki Fujii , Takamichi Kanbayashi , Kazusa Takahashi , Yuichi Hamada , Shunsuke Kobayashi , Masahiro Sonoo","doi":"10.1016/j.cnp.2025.02.003","DOIUrl":"10.1016/j.cnp.2025.02.003","url":null,"abstract":"<div><h3>Objective</h3><div>Decrement responses in repetitive nerve stimulation (RNS) are theoretically expected to correlate with the disease progression speed in amyotrophic lateral sclerosis (ALS). However, actual results have been controversial. We investigated this issue using ΔFS calculated from the ALS functional rating scale revised version (ALSFRS-R) and the duration of illness.</div></div><div><h3>Methods</h3><div>RNS results of the abductor pollicis brevis, trapezius, and deltoid muscles in our previous study were reviewed. We investigated correlations and multiple regressions regarding decremental percentage (Decr%), the amplitude of the initial compound muscle action potential (Amp), and progression speed parameters, i.e. ΔFS or ΔUL-FS, the latter being the ΔFS for the upper-limb questions in ALSFRS-R.</div></div><div><h3>Results</h3><div>Included subjects were 124 patients with ALS, 47 of whom were upper-limb onset. Multiple regression analyses revealed that Decr% is largely determined by Amp and that Δ FS or ΔUL-FS showed no or little contributions to Decr%.</div></div><div><h3>Conclusions</h3><div>Decremental responses in RNS does not predict the speed of progression of the functional impairment in patients with ALS.</div></div><div><h3>Significance</h3><div>This study suggests that the decremental responses in RNS in ALS are contributed by the impaired neuromuscular transmission in chronic sprouts following extensive reinnervation, as well as by the immature sprouts.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 40-46"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488300","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 : 2025-01-01DOI: 10.1016/j.cnp.2025.02.009
Hung Hoang Dang , Khang Vinh Nguyen , Si Tri Le , Thuy Thi Vu , Vy Thi Yen Le , Thang Ba Nguyen , Hieu Le Trung Nguyen
Objective
Numerous studies have investigated predictors for mechanical ventilation (MV) in Guillain-Barré syndrome (GBS), with varying results. This study identifies factors associated with MV in both populations in Vietnam.
Methods
We retrospectively collected data on GBS patients at Children’s Hospital 2 and the University Medical Center Ho Chi Minh City from 2017 to 2021. Clinical characteristics were analyzed using multivariable logistic regression to identify predictors of MV. A bootstrapping stepwise approach was used to select the most appropriate predictors for the model.
Results
A total of 108 adults and 112 children were included, with 15 adults (13.8 %) and 10 children (8.9 %) requiring MV. Dysautonomia and facial palsy/bulbar weakness were more common in ventilated patients (P < 0.05). Multivariable analysis identified dysautonomia as the only significant predictor for MV in both adults (OR: 7.43, 95 % CI: 1.78–30.98) and children (OR: 13.6, 95 % CI: 1.20–154.79).
Conclusions
Dysautonomia is a significant predictor of MV in adults and children with GBS. Although facial palsy and bulbar weakness were not statistically significant predictors, their presence warrants careful monitoring.
Significance
This study provides insights into GBS in Vietnam and underscores dysautonomia as a predictor for MV, distinguishing it from findings in previous prognostic models.
{"title":"Prognostic factors of mechanical ventilation in Guillain–Barré syndrome among adults and children in Vietnam","authors":"Hung Hoang Dang , Khang Vinh Nguyen , Si Tri Le , Thuy Thi Vu , Vy Thi Yen Le , Thang Ba Nguyen , Hieu Le Trung Nguyen","doi":"10.1016/j.cnp.2025.02.009","DOIUrl":"10.1016/j.cnp.2025.02.009","url":null,"abstract":"<div><h3>Objective</h3><div>Numerous studies have investigated predictors for mechanical ventilation (MV) in Guillain-Barré syndrome (GBS), with varying results. This study identifies factors associated with MV in both populations in Vietnam.</div></div><div><h3>Methods</h3><div>We retrospectively collected data on GBS patients at Children’s Hospital 2 and the University Medical Center Ho Chi Minh City from 2017 to 2021. Clinical characteristics were analyzed using multivariable logistic regression to identify predictors of MV. A bootstrapping stepwise approach was used to select the most appropriate predictors for the model.</div></div><div><h3>Results</h3><div>A total of 108 adults and 112 children were included, with 15 adults (13.8 %) and 10 children (8.9 %) requiring MV. Dysautonomia and facial palsy/bulbar weakness were more common in ventilated patients (P < 0.05). Multivariable analysis identified dysautonomia as the only significant predictor for MV in both adults (OR: 7.43, 95 % CI: 1.78–30.98) and children (OR: 13.6, 95 % CI: 1.20–154.79).</div></div><div><h3>Conclusions</h3><div>Dysautonomia is a significant predictor of MV in adults and children with GBS. Although facial palsy and bulbar weakness were not statistically significant predictors, their presence warrants careful monitoring.</div></div><div><h3>Significance</h3><div>This study provides insights into GBS in Vietnam and underscores dysautonomia as a predictor for MV, distinguishing it from findings in previous prognostic models.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 90-94"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600923","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 : 2025-01-01DOI: 10.1016/j.cnp.2025.07.004
Zhiyong Lin , Jierong Mo , Peiyi Liu , Zhiquan Li , Ran Zhan , Jun Jiang , Tianen Zhou
Objective
To report and analyze a unique case of selective brachial plexopathy following carbon monoxide poisoning without central nervous system involvement.
Methods
Clinical examination, laboratory tests, neuroimaging, serial electrophysiological studies, and functional assessments were performed on a 25-year-old female presenting with severe left upper extremity weakness after CO exposure. Treatment included hyperbaric oxygen therapy, steroid therapy, and rehabilitation.
Results
Following carbon monoxide poisoning, the patient developed complete left upper extremity paralysis with selective C5-C7 motor deficits and preserved sensory function. Brain MRI showed no abnormalities. Electrophysiological studies confirmed preganglionic radiculopathy with reduced motor nerve amplitudes and normal sensory conduction. Ultrasonography demonstrated C5-C7 nerve root swelling. Following hyperbaric oxygen therapy, corticosteroids, and rehabilitation, motor function gradually recovered with distal grip strength reaching 86% of the unaffected side at 120-day follow-up.
Conclusions
This case demonstrates an uncommon manifestation of carbon monoxide poisoning characterized by isolated brachial radiculopathy with preserved central nervous system function on neuroimaging. These findings expand the recognized spectrum of carbon monoxide neurotoxicity.
Significance
This case expands our understanding of CO neurotoxicity beyond the traditional basal ganglia paradigm, emphasizing the importance of peripheral nervous system assessment even when central neuroimaging is normal.
{"title":"Brachial radiculopathy with intact central nervous system imaging following carbon monoxide poisoning: A case report","authors":"Zhiyong Lin , Jierong Mo , Peiyi Liu , Zhiquan Li , Ran Zhan , Jun Jiang , Tianen Zhou","doi":"10.1016/j.cnp.2025.07.004","DOIUrl":"10.1016/j.cnp.2025.07.004","url":null,"abstract":"<div><h3>Objective</h3><div>To report and analyze a unique case of selective brachial plexopathy following carbon monoxide poisoning without central nervous system involvement.</div></div><div><h3>Methods</h3><div>Clinical examination, laboratory tests, neuroimaging, serial electrophysiological studies, and functional assessments were performed on a 25-year-old female presenting with severe left upper extremity weakness after CO exposure. Treatment included hyperbaric oxygen therapy, steroid therapy, and rehabilitation.</div></div><div><h3>Results</h3><div>Following carbon monoxide poisoning, the patient developed complete left upper extremity paralysis with selective C5-C7 motor deficits and preserved sensory function. Brain MRI showed no abnormalities. Electrophysiological studies confirmed preganglionic radiculopathy with reduced motor nerve amplitudes and normal sensory conduction. Ultrasonography demonstrated C5-C7 nerve root swelling. Following hyperbaric oxygen therapy, corticosteroids, and rehabilitation, motor function gradually recovered with distal grip strength reaching 86% of the unaffected side at 120-day follow-up.</div></div><div><h3>Conclusions</h3><div>This case demonstrates an uncommon manifestation of carbon monoxide poisoning characterized by isolated brachial radiculopathy with preserved central nervous system function on neuroimaging. These findings expand the recognized spectrum of carbon monoxide neurotoxicity.</div></div><div><h3>Significance</h3><div>This case expands our understanding of CO neurotoxicity beyond the traditional basal ganglia paradigm, emphasizing the importance of peripheral nervous system assessment even when central neuroimaging is normal.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 324-330"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144713191","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 : 2025-01-01DOI: 10.1016/j.cnp.2025.03.004
Aoi Mase , Manabu Shibasaki , Hiroki Nakata
Objective
We investigated changing characteristics of somatosensory processing in adolescents, particularly sex differences, by comparing children, young adults, and males and females.
Methods
Participants included 26 elementary school children (ESC), 36 adolescents (ADO), and 36 college students (CS). We recorded somatosensory evoked potentials (SEPs) using electrical stimulation of the right median nerve. Peak latencies and amplitudes were measured for P12, N15, P18, and N30 at Fz, and for P12 (P1), N18 (N1), P22 (P2), N27 (N2), P3, N3, P45 (P4), and N60 (N4) at C3′.
Results
The P22 (P2) amplitude at C3′ decreased with age. The N15 amplitude at Fz was larger in females across all groups. P3 and N3 occurrence at C3′ decreased with age but remained high in ADO compared to CS. Correlation analysis showed a significant negative correlation between P22 (P2) amplitude at C3′ and age in ADO boys, but not in ADO girls, ESC boys, or ESC girls.
Conclusions
Somatosensory processing in ADO is not as mature as in CS, with sex differences between ADO boys and girls.
Significance
Our findings may aid understanding of neural activity in children with developmental disorders, supporting sensory-based therapies.
{"title":"Changing characteristics of somatosensory evoked potentials in adolescents","authors":"Aoi Mase , Manabu Shibasaki , Hiroki Nakata","doi":"10.1016/j.cnp.2025.03.004","DOIUrl":"10.1016/j.cnp.2025.03.004","url":null,"abstract":"<div><h3>Objective</h3><div>We investigated changing characteristics of somatosensory processing in adolescents, particularly sex differences, by comparing children, young adults, and males and females.</div></div><div><h3>Methods</h3><div>Participants included 26 elementary school children (ESC), 36 adolescents (ADO), and 36 college students (CS). We recorded somatosensory evoked potentials (SEPs) using electrical stimulation of the right median nerve. Peak latencies and amplitudes were measured for P12, N15, P18, and N30 at Fz, and for P12 (P1), N18 (N1), P22 (P2), N27 (N2), P3, N3, P45 (P4), and N60 (N4) at C3′.</div></div><div><h3>Results</h3><div>The P22 (P2) amplitude at C3′ decreased with age. The N15 amplitude at Fz was larger in females across all groups. P3 and N3 occurrence at C3′ decreased with age but remained high in ADO compared to CS. Correlation analysis showed a significant negative correlation between P22 (P2) amplitude at C3′ and age in ADO boys, but not in ADO girls, ESC boys, or ESC girls.</div></div><div><h3>Conclusions</h3><div>Somatosensory processing in ADO is not as mature as in CS, with sex differences between ADO boys and girls.</div></div><div><h3>Significance</h3><div>Our findings may aid understanding of neural activity in children with developmental disorders, supporting sensory-based therapies.</div></div>","PeriodicalId":45697,"journal":{"name":"Clinical Neurophysiology Practice","volume":"10 ","pages":"Pages 141-149"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820946","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 : 2025-01-01DOI: 10.1016/j.cnp.2025.05.002
Greta Gustafsson , Anders Broström , Eva Svanborg , Magnus Vrethem , Martin Ulander
Objectives
Previous research has indicated a low diagnostic yield of initial EEGs in epilepsy diagnosis in children. This study aimed at exploring factors affecting the diagnostic yield of a first EEG in different ages, and factors affecting the choice of EEG method.
Methods
1097 EEGs performed as first recordings in children with suspected epilepsy were retrospectively analysed and divided into age groups: ≤ 5, 6–11 and 12–17 years. EEGs were classified as wake recordings with or without provocations, and sleep recordings: spontaneous sleep, sleep induced by deprivation or by melatonin premedication.
Results
Epileptiform activity was found in 18 % of all patients, most common (30 %) in children 6–11 years old. It was more likely to be detected in melatonin-induced sleep EEGs compared to other types of sleep EEG. Presence of epileptiform discharges were positively associated to age, sleep, neurological and/or intellectual comorbidity in all children.
Conclusions
The prevalence of epileptiform activity varies depending on the child́s age. Sleep EEG is advantageous as first recording, especially in very young children or with neurological comorbidity.
Significance
Melatonin-induced sleep EEG has higher diagnostic yield compared to other types of sleep EEG. Age, seizure semiology and comorbidity affect the choice of EEG method.
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