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Effects of Anesthetic Regimens and Other Confounding Factors Affecting the Interpretation of Motor Evoked Potentials During Pediatric Spine Surgery 麻醉方案和其他混杂因素对小儿脊柱手术中运动诱发电位解释的影响
Pub Date : 2010-09-01 DOI: 10.1080/1086508X.2010.11079776
Mark J Balvin, Kit M. Song, J. Slimp
ABSTRACT. Children undergoing corrective spine surgery are at risk of serious neurologic injury. Monitoring transcranial electric motor evoked potentials (TCeMEPs) during these procedures may identify and help prevent injury to motor pathways. The difficulty in obtaining consistent motor evoked potential (MEP) responses during pediatric spine surgery can result in part to the suppression of evoked responses caused by volatile inhalational anesthetics, elevated levels of propofol, and/or physiologic variables. Data obtained from 140 pediatric patients who underwent spine surgery with MEP monitoring were retrospectively analyzed and evaluated for age and anesthetic effects on stimulation variables. MEPs acquired under inhalational anesthetic agents required greater stimulation compared to intravenous propofol anesthesia. Additionally, the responses were more variable when inhalational agents were used. These effects were more prominent in younger age patients. The number of alerts of MEP loss or reduction related to anesthetic levels or blood pressure changes was higher under inhalational agents.
摘要接受脊柱矫正手术的儿童有严重神经损伤的风险。在这些过程中监测经颅运动诱发电位(TCeMEPs)可以识别和帮助预防运动通路的损伤。在小儿脊柱手术中,难以获得一致的运动诱发电位(MEP)反应,部分原因可能是挥发性吸入麻醉剂、异丙酚水平升高和/或生理变量引起的诱发反应受到抑制。本研究回顾性分析了140例在MEP监测下接受脊柱手术的儿童患者的数据,并评估了年龄和麻醉对刺激变量的影响。与静脉异丙酚麻醉相比,吸入麻醉下获得的mep需要更大的刺激。此外,当使用吸入性药物时,反应变化更大。这些影响在年轻患者中更为突出。吸入药物组MEP丢失或减少与麻醉水平或血压变化相关的报警次数更高。
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引用次数: 18
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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