Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
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EEG is a popular, low-cost examination used in neurologic and nonneurologic evaluations. Nevertheless, the diagnostic usefulness of EEG has some limitations, and it may increase medical costs. The manifestations of syncope may lead to misdiagnoses, and frequently, it is mislabeled as epilepsy. ⋯ Bilateral slow waves were more prevalent among adults. We conclude that EEG is not useful for evaluating the diagnosis of syncope because of its very low diagnostic yield. Patients with syncope must have a correct history and physical examination plus cardiovascular tests.
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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.
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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.
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J Clin Neurophysiol · Oct 2011
Application of electrophysiologic techniques in poor outcome prediction among patients with severe focal and diffuse ischemic brain injury.
To explore various electrophysiologic examinations as predictors for poor outcome in patients with severe ischemic brain injury, by comparing the prognostic ability of EEG, short-latency somatosensory evoked potentials (SLSEP), and brain stem auditory evoked potentials (BAEP). ⋯ The predictive power of electrophysiologic examinations is different according to the etiology of ischemic brain injury. Short-latency somatosensory evoked potentials (N20) can be considered the most powerful method to predict poor outcome in anoxic-ischemic encephalopathy. Combination of EEG (unfavorable EEG patterns) and SLSEP (N20)/BAEP (wave V) is best suited in massive hemispheric infarction to predict poor outcome.
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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.