Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
-
J Clin Neurophysiol · Feb 2012
Test-retest reliability of contact heat-evoked potentials from cervical dermatomes.
The purpose of this study was to investigate the test-retest reliability of contact heat-evoked potentials (CHEPs) in neurologically healthy subjects from cervical dermatomes (C4-C8). Seventeen individuals underwent test-retest examination of cervical CHEPs. Peak latencies and peak-to-peak amplitude of N2-P2 and ratings of perceived intensity were analyzed using test-retest reliability statistics (intraclass correlation coefficients [ICCs] and Bland-Altman confidence parameters). ⋯ Superior peak-to-peak amplitude test-retest reliability was found for CHEPs. In conclusion, the test-retest reliability of dSSEP and CHEP parameters supports the fact that these outcomes can be used to objectively track changes in spinal conduction in the dorsal column and spinothalamic tract, respectively. The reliable acquisition of CHEPs may depend on the intensity of the sensation reported by the subject for a given area of skin stimulated.
-
J Clin Neurophysiol · Dec 2011
ReviewNeurophysiologic intraoperative monitoring of the glossopharyngeal and vagus nerves.
Neurophysiologic intraoperative monitoring (NIOM) of the glossopharyngeal and vagus nerves (CN IX and X) is often used during surgeries involving the lower brain stem. Although both of these nerves contain sensory, autonomic, and motor fibers, it is the motor fibers that are most amenable to NIOM. CN IX supplies the stylopharyngeus muscle, and CN X supplies striated muscles in the soft palate, pharynx, and larynx. ⋯ Various surface and needle electrodes can be used to monitor these muscle groups. When CN IX is monitored, CN X should also be monitored, as it is often needed to differentiate when CN IX is selectively activated. Data are accumulating noting the use of monitoring these CN in tumor surgeries involving the lower brain stem.
-
The aim was to determine the electroencephalographic (or electroencephalogram [EEG]) findings predictive of functional outcome in a subset of patients with acute subdural hematoma (SDH) with epileptiform activity on their EEG. Twenty-four patients who underwent evacuation for acute or acute-on-chronic SDH and with epileptiform activity on EEG were identified retrospectively. Their EEGs were reviewed and the findings categorized along with clinical information, the preoperative computed tomography (CT) scan, and functional outcome. ⋯ The EEG findings in this group of patients were complex. Epileptiform discharges were common, and specific types were associated with midline shift on neuroimaging and poor functional outcome at hospital discharge. Improvement in follow-up EEG examinations over time was predictive of good long-term functional outcome.
-
J Clin Neurophysiol · Oct 2011
Usefulness of standard EEG in predicting the outcome of patients with disorders of consciousness after anoxic coma.
Although standard EEG is performed routinely in patients with disorders of consciousness after coma, its prognostic value is still debated. The aim of the present study was to evaluate the role of standard EEG in predicting the recovery of cognitive functioning in patients affected by severe disturbances of consciousness after coma caused by cerebral anoxia. A standard EEG was recorded at admission to our Rehabilitation Department in 15 patients experiencing impaired consciousness because of cerebral anoxia. ⋯ EEG scores were significantly correlated with both levels of cognitive functioning scores at admission (P = 0.004) and change in levels of cognitive functioning score after 3 months (P < 0.001). The first correlation confirms the relationship between EEG and cognitive functioning, while the second correlation indicates the prognostic value of EEG in cognitive outcome. In conclusion, standard EEG is a simple and readily available tool with significant prognostic value in patients with disorders of consciousness after coma caused by cerebral anoxia.
-
In this study, the authors characterized the clinical and EEG features of adult patients with Down syndrome who were referred, for more than a 10-year period, to the Epilepsy Clinic in the Cork University Hospital. A retrospective audit of the charts of 28 patients with Down syndrome who had an EEG performed in the Cork University Hospital between January 1, 2000, and September 30, 2009, including clinical follow-up, was carried out. Demographics, age at first seizure, seizure types, EEG findings, antiepileptic drugs, psychoactive medications, and seizure control were documented. ⋯ Five of the 28 patients had a normal EEG and 3 of these had a seizure disorder. There was no correlation found between use of psychoactive drugs and increased frequency/poor seizure control in patients in our study. This study documents the variability of clinical and electrophysiologic features in a well-characterized cohort of patients with Down syndrome with adult-onset epilepsy.