Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
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J Clin Neurophysiol · Feb 2011
Multicenter StudyPrevalence of peripheral neuropathy and painful peripheral neuropathy in Turkish diabetic patients.
The aim of this study was to determine the prevalence of diabetic peripheral neuropathy (DPN) and neuropathic pain in diabetic patients attending university outpatient clinics in Turkey. In this multicenter cross-sectional study, neurologic examinations and nerve conduction studies along with clinical diabetic neuropathy score, and Leeds Assessment of Neuropathic Symptoms and Signs pain scale were performed on 1,113 patients (46.2% male) from 14 centers. Prevalence of DPN determined only by clinical examination was 40.4% and increased to 62.2%, by combining nerve conduction studies with clinical examination. ⋯ Poor glycemic control, retinopathy, microalbuminuria, hyperlipidemia, diabetic foot, and foot amputation were more commonly observed in patients with DPN. Clinical DPN affected 40.4% of diabetic patients, and neuropathic pain prevalence in diabetic patient population was 14.0%. Clinical examinations and nerve conduction studies are important components for early detection and accurate diagnosis of DPN and painful DPN.
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J Clin Neurophysiol · Feb 2011
Agreement between long-term neonatal background classification by conventional and amplitude-integrated EEG.
Conventional EEG (CEEG) in neonates is considered the gold standard for evaluating EEG background and detecting electrographic seizures. However, CEEG is expensive and cumbersome for long-term monitoring. A simplified method, amplitude-integrated EEG (AEEG) has been rapidly adopted to accomplish the same goals. ⋯ Although there was overall significant moderate agreement between the two techniques, the distribution of backgrounds assigned by AEEG was significantly different from CEEG. Most moderately abnormal AEEGs were associated with normal or mildly abnormal CEEGs. However, the ability of moderately abnormal AEEGs to correctly predict moderately or markedly abnormal CEEG was significantly associated with the knowledge of the patient's age and the presence of seizures on CEEG.
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J Clin Neurophysiol · Feb 2011
Microvascular decompression for hemifacial spasm: evaluating outcome prognosticators including the value of intraoperative lateral spread response monitoring and clinical characteristics in 293 patients.
Hemifacial spasm is a socially disabling condition that manifests as intermittent involuntary twitching of the eyelid and progresses to muscle contractions of the entire hemiface. Patients receiving microvascular decompression of the facial nerve demonstrate an abnormal lateral spread response (LSR) in peripheral branches during facial electromyography. The authors retrospectively evaluate the prognostic value of preoperative clinical characteristics and the efficacy of intraoperative monitoring in predicting short- and long-term relief after microvascular decompression for hemifacial spasm. ⋯ Multivariate logistic regression analysis demonstrated independent predictability of residual LSR for present spasm within 24 hours of surgery and at discharge but not at follow-up. Facial electromyography monitoring of the LSR during microvascular decompression is an effective tool in ensuring a complete decompression with long-lasting effects. Although LSR results predict short-term outcomes, long-term outcomes are not as reliant on LSR activity.
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J Clin Neurophysiol · Feb 2011
Interobserver reproducibility of electroencephalogram interpretation in critically ill children.
Correct outcome prediction after cardiac arrest in children may improve clinical decision making and family counseling. Investigators have used EEG to predict outcome with varying success, but a limiting issue is the potential lack of reproducibility of EEG interpretation. Therefore, the authors aimed to evaluate interobserver agreement using standardized terminology in the interpretation of EEG tracings obtained from critically ill children after cardiac arrest. ⋯ The variability of interrater agreement suggests that some EEG features are superior to others for use in a predictive algorithm. Using only reproducible EEG features is needed to ensure the most accurate and consistent predictions. Because even seizure identification had only moderate agreement, studies of nonconvulsive seizures in critically ill patients must be conducted and interpreted cautiously.
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J Clin Neurophysiol · Feb 2011
Comparative StudyClinical severity, rather than body temperature, during the rewarming phase of therapeutic hypothermia affect quantitative EEG in neonates with hypoxic ischemic encephalopathy.
EEG is important in monitoring neonates with hypoxic-ischemic encephalopathy (HIE) during hypothermia therapy (HT). Although EEG is used to evaluate the severity of HIE and predict outcome, HT itself may affect EEG parameters. The goal of this study is to evaluate whether core body temperature (CBT) during the rewarming phase of HT in neonates with HIE changes quantified EEG parameters. ⋯ HIE severity and length of stay but not CBT affect quantified EEG. Findings suggest quantified EEG is reliable during HT. In addition, EEG may aid in predicting short-term outcome of neonates with HIE.