Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society
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J Clin Neurophysiol · Dec 2015
ReviewACNS Critical Care EEG Terminology: Value, Limitations, and Perspectives.
The interpretation of the EEG in the critically ill remains a clinical challenge. Because continuous EEG monitoring plays an increasing role in patients' care, it is important that research efforts investigate the clinical significance of periodic and rhythmic discharges and of background abnormalities. ⋯ Studies using the terminology have already started to define the clinical and prognostic values of several known or newly described EEG patterns. Yet, as the field of critical care EEG evolves, improvements will be required to further enhance the clarity of the terminology and incorporate new findings from ongoing research.
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J Clin Neurophysiol · Dec 2015
Clinical Usefulness of Somatosensory Evoked Potentials for Detection of Peripheral Nerve and Brachial Plexus Injury Secondary to Malpositioning in Microvascular Decompression.
Neurologic injury secondary to positioning is a significant perioperative problem and a common cause of patient injury in the practice of surgery. Somatosensory evoked potentials' (SSEPs) monitoring has also been noted useful in evaluating upper extremity conduction changes related to positioning. The purpose of this article was to evaluate the effectiveness of intermittent monitoring of SSEPs, which detects peripheral nerve and brachial plexus injury caused by malpositioning during microvascular decompression (MVD). This article will also discuss the etiology and pathogenesis of nerve injury after MVD and the means to prevent them. ⋯ When positioning the patient for MVD with lateral position, careful attention should be paid to both the dependent (lower) arm extremities and the upper shoulders to prevent peripheral nerve injury. Additional precautions should be taken if the patient has a low body mass index or diabetes. Continuous intraoperative SSEP monitoring of ulnar/median nerve function is a valid and useful technique to minimize intraoperative neurologic injuries during surgery.
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J Clin Neurophysiol · Aug 2015
Diagnostic Accuracy of Electrographic Seizure Detection by Neurophysiologists and Non-Neurophysiologists in the Adult ICU Using a Panel of Quantitative EEG Trends.
To evaluate the sensitivity and specificity of a panel of quantitative EEG (qEEG) trends for seizure detection in adult intensive care unit (ICU) patients when reviewed by neurophysiologists and non-neurophysiologists. ⋯ Quantitative EEG display panels are a promising tool to aid detection of seizures by non-neurophysiologists as well as by neurophysiologists. However, even when used as a panel, qEEG trends do not appear to be adequate as the sole method for reviewing continuous EEG data.