The Neurodiagnostic journal
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Distinguishing obstructive sleep apnea from central apnea depends upon accurate measure of chest and abdominal movement. American Academy of Sleep Medicine (AASM) polysomnography guidelines recommend the use of respiratory inductive plethysmography (RIP) belts but not piezoelectrode (PE) belts for measuring chest and abdominal movements. To compare these two sensors, we measured the signal amplitude for 10 RIP belts and 10 PE belts stretched by mechanical distraction across six distances (2.5 to 15.0 centimeters) and replicated 10 times for each belt. ⋯ Signals from PE belts highly correlated with the distance of distraction (r = 0.96 to 0.99) and the RIP belts (r = 0.98 to 0.99). These results suggest that PE belts perform similarly to RIP belts at distraction distances up to 10.0 centimeters. Further testing on biological models is needed to determine if PE belts are a suitable alternative for RIP belts in polysomnography.
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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.
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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.