The Neurodiagnostic journal
-
Case Reports
The importance of cardiac monitoring in the epilepsy monitoring unit: a case presentation of ictal asystole.
Ictal asystole may be a potent marker for epilepsy patients at high risk for sudden unexpected death in epilepsy (SUDEP). The use of inpatient long-term video-electroencephalographic (VEEG) monitoring coupled with simultaneous continuous cardiac telemetry is an important tool to detect ictal asystole as well as other significant ictal cardiac arrhythmias. In this paper a case of ictal asystole detected during VEEG is presented. ⋯ A 20 second period of asystole began just prior to the secondary generalization. During this admission the patient underwent a potentially life-saving pacemaker implantation. The use of cardiac telemetry and baseline EKG are suggested for patients admitted into epilepsy monitoring units as part of the standard epilepsy monitoring protocol.
-
Review
Current trends in pedicle screw stimulation techniques: lumbosacral, thoracic, and cervical levels.
Unequivocally, pedicle screw instrumentation has evolved as a primary construct for the treatment of both common and complex spinal disorders. However an inevitable and potentially major complication associated with this type of surgery is misplacement of a pedicle screw(s) which may result in neural and vascular complications, as well as impair the biomechanical stability of the spinal instrumentation resulting in loss of fixation. In light of these potential surgical complications, critical reviews of outcome data for treatment of chronic, low-back pain using pedicle screw instrumentation concluded that "pedicle screw fixation improves radiographically demonstrated fusion rates;" however the expense and complication rates for such constructs are considerable in light of the clinical benefit (Resnick et al. 2005a). ⋯ In particular free-run and triggered EMG have been well recognized in numerous publications for improving both the accuracy and safety of pedicle screw implantation. Currently, treatment with pedicle screw instrumentation routinely involves all levels of the spine - lumbosacral, thoracic, and cervical. Significant historical events, various neuromonitoring modalities, intraoperative alarm criteria, clinical efficacy, current trends, and caveats related to pedicle screw stimulation along the entire vertebral column will be reviewed.
-
Review Case Reports
Reversible posterior leukoencephalopathy syndrome: a case presentation.
Reversible posterior leukoencephalopathy syndrome (RPLS) is encountered in many subspecialty areas of medical practice but is seen relatively infrequently by the neurodiagnostic technologist. There are several different names for this condition including: reversible posterior leukoencephalopathy, reversible posterior leukoencephalopathy syndrome, posterior reversible encephalopathy syndrome, and hypertensive encephalopathy. A brief review of RPLS and the case presentation of a woman who developed eclampsia, temporary blindness, and recurrent seizures captured by EEG/video monitoring are presented in this paper EEG samples and brain magnetic resonance imaging (MRI) changes related to RPLS are highlighted.