Neurophysiologie clinique = Clinical neurophysiology
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Seizures are common in critically ill patients and prevalence can exceed 30% in the neuro-intensive care unit (ICU). Continuous EEG monitoring (cEEG) is the gold standard for seizure detection in critically ill patients. ⋯ iEEG repeated every 6hours can accurately detect patients presenting seizures, especially when seizure frequency is greater than six per 24hours. These findings have practical implications for electrographic seizure detection in critically ill patients in settings lacking cEEG.
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Prepulse inhibition (PPI) of the blink reflex (BR) is a reduction in BR excitability due to a conditioning stimulus, reflecting sensory gating by brainstem structures. We aimed to analyze PPI changes during a painful episode in chronic or episodic migraine and its relation to allodynia, since abnormal brainstem filtering has been hypothesized in migraine pathophysiology. ⋯ Our study provides evidence for sensory gating impairment at brainstem level in migraine headache, related to the presence of allodynia.
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Case Reports
Not everything that shakes is a seizure… Role of continuous EEG in the intensive care unit.
Treatment of status epilepticus often requires highly sedative drugs with risk of side effects. Correct diagnosis is mandatory in order to prevent introduction of usefulness treatments. ⋯ A thalamic lesion secondary to an osmotic demyelination syndrome was found to be the likely etiology of the myoclonus. Electrophysiological data (electroencephalography and electromyography) provided evidence for a subcortical origin of myoclonus and use of continuous EEG allowed monitoring of drug withdrawal.