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Potential Neurological Risk during a Titanium Rib Procedure and Appropriate Intraoperative Neurophysiologic Monitoring Modalities 钛肋手术中潜在的神经系统风险和适当的术中神经生理监测方式
Pub Date : 2010-09-01 DOI: 10.1080/1086508X.2010.11079774
Megan T Roper
ABSTRACT. The titanium rib procedure is a safe and effective way of surgically treating pediatric patients with thoracic insufficiency syndrome and scoliosis. As with any invasive surgical procedure, it is not without risks. This article explains the potential risks to neurological structures while outlining the surgical approach and the neurological anatomy in the vicinity of the implanted instrumentation. The types of potential nerve injury involve ischemia, trauma, compression, and stretch. Furthermore, a suitable compilation of modalities of intraoperative neurophysiologic monitoring is recommended to detect and avoid long-term nerve or spinal cord insult. Monitoring modalities that would be appropriate for this procedure are discussed.
摘要钛肋手术是一种安全有效的手术治疗小儿胸功能不全综合征和脊柱侧凸的方法。与任何侵入性外科手术一样,它也不是没有风险的。这篇文章解释了对神经结构的潜在风险,同时概述了手术入路和植入内固定装置附近的神经解剖学。潜在的神经损伤类型包括缺血、创伤、压迫和拉伸。此外,我们推荐一套合适的术中神经生理监测模式来检测和避免长期的神经或脊髓损伤。讨论了适用于这一程序的监测方式。
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引用次数: 0
Waveform window #18. Troubleshoot this. 波形窗口#18。解决这个问题。
Cindy Fujimura, Andrea Cheng-Hakimian
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引用次数: 0
Neurocysticercosis: Fireflies in the Central Nervous System 神经囊虫病:中枢神经系统中的萤火虫
Pub Date : 2010-09-01 DOI: 10.1080/1086508X.2010.11079777
V. Wiwanitkit
I read the recent publication on neurocysticercosis (Davidson 2010) with great interest. I would like share some ideas on this specific issue. Indeed, the problem of diagnosis of neurocysticercosis exists. The use of neuroimaging technique for diagnosis of neurocysticercosis is widely discussed. The use of entire body imaging is mentioned for usefulness but there are also several limitations (Wiwanitkit 2010). Based on the neuroimaging system, there are many neurological infections that might present mimicking pictures to neurocysticercosis and this is an important issue in diagnostic medicine in tropical setting (Wiwanitkit 2010, Gulati et al. 2010). An important point for differentiation of neurocysticercosis from other similar neurological infections is the history of the patient (ingestion of uncooked pork, poor toileting, and eating behavior). The use of neuroimaging technique for diagnosis of neurocysticercosis has to be accompanied with good history taking.
我饶有兴趣地阅读了最近关于神经囊虫病的出版物(Davidson 2010)。我想就这个问题谈几点看法。神经囊虫病的诊断确实存在问题。神经影像技术在神经囊虫病诊断中的应用被广泛讨论。使用全身成像是有用的,但也有一些限制(Wiwanitkit 2010)。基于神经成像系统,有许多神经系统感染可能呈现与神经囊虫病相似的图像,这是热带环境诊断医学中的一个重要问题(Wiwanitkit 2010, Gulati et al. 2010)。区分神经囊虫病与其他类似神经系统感染的一个重要要点是患者的病史(摄入生猪肉、如厕不良和饮食行为)。应用神经影像学技术诊断脑囊虫病必须有良好的病史记录。
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引用次数: 0
Credentialing Organizations 的认证机构
Pub Date : 2010-09-01 DOI: 10.1080/1086508x.2010.11079782
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引用次数: 0
Brain computer interface (BCI) tools developed in a clinical environment. 在临床环境下开发脑机接口(BCI)工具。
Nicholas R Anderson, Elise M DeVries

Brain computer interfaces are devices that collect signals from a subject's cortical surface and interpret these signals to control a computer Recently much development has been done on these devices with the help of epilepsy patients and the clinical staff who treat these patients. The types of data collected from epilepsy patients, particularly the invasive data give a unique opportunity to researchers in this area. The clinical staff has a unique opportunity to use the treatment of one patient population to help another

脑机接口是一种设备,它从受试者的皮层表面收集信号,并解释这些信号来控制计算机。最近,在癫痫患者和治疗这些患者的临床工作人员的帮助下,这些设备取得了很大的进展。从癫痫患者收集的数据类型,特别是侵入性数据,为这一领域的研究人员提供了独特的机会。临床工作人员有一个独特的机会,利用一个病人群体的治疗来帮助另一个病人群体
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引用次数: 0
Historical archives. 历史档案。
Lucy R Sullivan
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引用次数: 0
Electrical stimulation and electrode properties. Part 1: clinical electrodes. 电刺激和电极特性。第1部分:临床电极。
Matthew Stevenson, Kelly Baylor, Brett L Netherton, Mark M Stecker
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引用次数: 0
Electrical Status Epilepticus during Sleep: A Case Report and Review of the Literature 睡眠中癫痫持续状态:1例报告及文献回顾
Pub Date : 2010-09-01 DOI: 10.1080/1086508X.2010.11079775
Jie Zhang, G. Talley, Adam L. Kornegay, J. Edwards
ABSTRACT. We present the case of a 5-year-old male who other than being six weeks premature at birth had no significant early medical problems, and had normal physical and cognitive development until preschool. It was then that his teacher noticed the child was having learning difficulties, staring spells, and difficulty expressing himself He had a single generalized tonic-clonic seizure (GTCS) in September of 2008. A routine EEG revealed very frequent epileptiform discharges. He was started on levetiracetam and four months later his EEG showed continuous spike wave discharges during sleep. The spike wave discharges occurred in long runs, lasting a minute or more, without clear ictal evolution. The spike wave discharges were seen in a generalized distribution, maximal bifronto-temporally with some asymmetry (right greater than left). When the patient was subsequently awakened, the EEG dramatically improved and the spike wave discharges almost completely resolved. The spike and wave discharges recurred as the patient became drowsy again. Authors have described this as electro graphic status during sleep (ESES) which is a typical childhood process of generalization of paroxysmal activity and can be seen with specific childhood epileptic encephalopathies. Treatment with levetiracetam was increased and his EEG and language subsequently returned to normal.
摘要我们提出的情况下,一个5岁的男性谁除了早产六周没有显著的早期医疗问题,并有正常的身体和认知发展,直到学龄前。就在那时,他的老师注意到这个孩子有学习困难,盯着看,难以表达自己。他在2008年9月有过一次全身性强直阵挛发作(GTCS)。常规脑电图显示非常频繁的癫痫样放电。他开始服用左乙拉西坦,4个月后,他的脑电图显示他在睡眠时连续出现尖峰波放电。尖峰波放电发生在长时间,持续一分钟或更长时间,没有明显的临界演化。尖峰波放电呈广义分布,最大的双阵时间有一定的不对称性(右大于左)。当病人随后被唤醒时,脑电图显著改善,尖峰波放电几乎完全消除。当病人再次昏昏欲睡时,尖峰和波状放电再次出现。作者将其描述为睡眠期间的电图状态(ESES),这是一个典型的儿童期阵发性活动普遍化过程,可以在特定的儿童期癫痫性脑病中看到。左乙拉西坦治疗增加,脑电图和语言随后恢复正常。
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引用次数: 5
Electrical Stimulation and Electrode Properties. Part 1: Clinical Electrodes 电刺激和电极特性。第一部分:临床电极
Pub Date : 2010-09-01 DOI: 10.1080/1086508X.2010.11079772
M. Stevenson, K. Baylor, B. Netherton, M. Stecker
ABSTRACT. Few studies have addressed the changes that can occur in clinical electrodes during high amplitude electrical stimulation. In this study, the response of some common clinical electrodes to various types of electrical stimulation was investigated. This included studies of the effect of pulse and direct currents, design and material of electrode, and the effects of voltage and current levels. There were significant changes to the weight and shape of a stainless steel anode during stimulation that were more dramatic as the duration of the stimulus pulse increased and were most severe with direct current (DC) stimuli. Pulse stimulus currents below 5 mA did not result in any stimulation related changes and pulse durations less than 1 msec did not produce any changes in the electrode. Not all effects of stimulation were on the electrode itself. Stimulation did also have a significant effect on the electrode lead-wire connection as well, depending on the details of the manufacture of the electrode.
摘要很少有研究涉及临床电极在高振幅电刺激期间可能发生的变化。在这项研究中,研究了一些常见的临床电极对不同类型电刺激的反应。这包括研究脉冲和直流电的影响,电极的设计和材料,以及电压和电流水平的影响。在刺激过程中,不锈钢阳极的重量和形状发生了显著变化,随着刺激脉冲持续时间的增加,这种变化更为剧烈,在直流(DC)刺激下最为严重。低于5 mA的脉冲刺激电流不会导致任何与刺激相关的变化,小于1 msec的脉冲持续时间不会对电极产生任何变化。并不是所有的刺激作用都发生在电极上。刺激对电极引线连接也有显著影响,这取决于电极制造的细节。
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引用次数: 3
Electrical status epilepticus during sleep: a case report and review of the literature. 睡眠期间的电性癫痫持续状态:1例报告及文献回顾。
Jie Zhang, Gregory Talley, Adam L Kornegay, Jonathan C Edwards

We present the case of a 5-year-old male who other than being six weeks premature at birth had no significant early medical problems, and had normal physical and cognitive development until preschool. It was then that his teacher noticed the child was having learning difficulties, staring spells, and difficulty expressing himself He had a single generalized tonic-clonic seizure (GTCS) in September of 2008. A routine EEG revealed very frequent epileptiform discharges. He was started on levetiracetam and four months later his EEG showed continuous spike wave discharges during sleep. The spike wave discharges occurred in long runs, lasting a minute or more, without clear ictal evolution. The spike wave discharges were seen in a generalized distribution, maximal bifronto-temporally with some asymmetry (right greater than left). When the patient was subsequently awakened, the EEG dramatically improved and the spike wave discharges almost completely resolved. The spike and wave discharges recurred as the patient became drowsy again. Authors have described this as electrographic status during sleep (ESES) which is a typical childhood process of generalization of paroxysmal activity and can be seen with specific childhood epileptic encephalopathies. Treatment with levetiracetam was increased and his EEG and language subsequently returned to normal.

我们提出的情况下,一个5岁的男性谁除了早产六周没有显著的早期医疗问题,并有正常的身体和认知发展,直到学龄前。就在那时,他的老师注意到这个孩子有学习困难,盯着看,难以表达自己。他在2008年9月有过一次全身性强直阵挛发作(GTCS)。常规脑电图显示非常频繁的癫痫样放电。他开始服用左乙拉西坦,4个月后,他的脑电图显示他在睡眠时连续出现尖峰波放电。尖峰波放电发生在长时间,持续一分钟或更长时间,没有明显的临界演化。尖峰波放电呈广义分布,最大的双阵时间有一定的不对称性(右大于左)。当病人随后被唤醒时,脑电图显著改善,尖峰波放电几乎完全消除。当病人再次昏昏欲睡时,尖峰和波状放电再次出现。作者将其描述为睡眠期间的电图状态(ESES),这是一个典型的儿童期阵发性活动泛化过程,可以在特定的儿童期癫痫性脑病中看到。左乙拉西坦治疗增加,脑电图和语言随后恢复正常。
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引用次数: 0
期刊
American Journal of Electroneurodiagnostic Technology
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