Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
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J Clin Neurophysiol · Dec 2013
Simultaneous direct cortical motor evoked potential monitoring and subcortical mapping for motor pathway preservation during brain tumor surgery: is it useful?
The warning-sign hierarchy between quantitative subcortical motor mapping and continuous motor evoked potential monitoring during resection of supratentorial brain tumors: clinical article.Seidel K, Beck J, Steiglitz L, Schucht P, Raabe A.J Neurosurg 2013; 118:287-296. ⋯ Mapping should primarily guide tumor resection adjacent to the CST. Direct cortical stimulation-motor evoked potential is a useful predictor of deficits, but its value as a warning sign is limited because signal alterations were reversible in only approximately 60% of the present cases and irreversibility is a post hoc definition. The true safe mapping MT is lower than previously thought. The authors postulate a mapping MT of 1 mA or less where irreversible DCS-MEP changes and motor deficits regularly occur. Therefore, they recommend stopping tumor resection at an MT of 2 mA at the latest. The limited spatial and temporal coverage of contemporary mapping may increase error and may contribute to false, higher MTs.
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This article serves to (1) review the relationship of the terms "delirium" and "encephalopathy," (2) describe delirium as defined in current diagnostic systems, (3) summarize the epidemiology and theories of pathogenesis, (4) review clinical diagnostic approaches, and (5) highlight the history using EEG in the study of delirium in the psychiatric literature. Delirium is an important medical syndrome with significant implications; there is continued need for better physiologic measures of the underlying brain dysfunction.
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This review will discuss several intracranial infections and sepsis-associated encephalopathy. Intracranial infections and inflammation of interest to the neurologist and EEG technicians include viral and autoimmune encephalitides; bacterial, fungal, and other meningitides; cerebritis; and brain abscess and subdural empyema. Sepsis-associated encephalopathy refers to a diffuse brain dysfunction secondary to infection that is principally located outside of the central nervous system. ⋯ It probably involves a number of mechanisms that are not mutually exclusive and likely vary from patient to patient. Morbidity and mortality are directly related to the severity of SAE. The earliest features of SAE are delirium and mild EEG slowing; it is crucial to recognize these early features and to search for and treat the underlying infection promptly to reduce mortality and morbidity.
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J Clin Neurophysiol · Aug 2013
Comparative StudyDensity spectral array for seizure identification in critically ill children.
We evaluated the validity and interrater reliability of encephalographer interpretation of color density spectral array EEG for seizure identification was evaluated in critically ill children and explored predictors of accurate seizure identification. ⋯ Color density spectral array may be a useful screening tool for seizure identification by encephalographers, but it does not identify all seizures and false positives occur.
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J Clin Neurophysiol · Aug 2013
Case ReportsStatus epilepticus amauroticus and posterior reversible encephalopathy syndrome in children.
Transient cortical visual impairment is a common aura of occipital lobe seizures. However, status amauroticus for hours has rarely been described as a manifestation of occipital lobe status epilepticus. ⋯ Reversible status amauroticus because of occipital lobe status epilepticus may be the presenting symptom of posterior reversible encephalopathy syndrome and EEG recording should be performed.