Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
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Elevated serum levels of creatine kinase (CK) reflect skeletal muscle injury, which may lead to renal dysfunction following surgery. High CK levels are known to occur after neurosurgical interventions, especially following lateral positioning, but a consensus on possible risk factors is still lacking. Here we investigate risk factors for postoperative CK excess in a patient population at high risk (lateral position) with a special focus on the influence of intraoperative neurophysiological monitoring (IONM), particularly Motor Evoked Potentials (MEPs). ⋯ In patients undergoing long neurosurgeries without muscle relaxants, we recommend special care regarding positioning and perioperative management.
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Acupuncture is known to reduce clinical pain, although the exact mechanism is unknown. The aim of the current study was to investigate the effect of acupuncture on laser-evoked potential amplitudes and laser pain perception. ⋯ Our results provide a theoretical background for the use of abdominal acupuncture as a therapeutic approach in the treatment of pain conditions. Future studies will have to be conducted in clinical painful syndromes, in order to confirm the analgesic effect of acupuncture in patients suffering from pain.
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Randomized Controlled Trial Comparative Study
Transcranial motor evoked potentials during anesthesia with desflurane versus propofol--A prospective randomized trial.
This study aimed to evaluate differences in transcranial electrical motor evoked potential (tcMEP) amplitudes between desflurane/remifentanil and propofol/remifentanil anesthesia treatment plans in patients without preexisting motor deficits (PMDs) undergoing carotid endarterectomy (CEA). ⋯ TcMEPs were recorded in all patients regardless of the anesthesia regimen. In patients with initially small amplitudes, desflurane may limit tcMEP recording because it produces a remarkable amplitude reduction, even in patients without PMDs.
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Randomized Controlled Trial
Inter-rater agreement on identification of electrographic seizures and periodic discharges in ICU EEG recordings.
This study investigated inter-rater agreement (IRA) among EEG experts for the identification of electrographic seizures and periodic discharges (PDs) in continuous ICU EEG recordings. ⋯ This study demonstrates more disagreement in the labeling of PDs in comparison to seizures. This may be improved by education about standard EEG nomenclature.
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Delayed cerebral infarction (DCI) has a significant impact on mortality and morbidity of patients with subarachnoid hemorrhage (SAH). The aim of this study was to define quantitative EEG (qEEG) parameters for the early and reliable prediction of DCI and compare the validity and time course of qEEG to standard procedures. ⋯ qEEG indicates imminent ischemia earlier than established diagnostic tools, such as TCD.