Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
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To determine whether sleepiness and its evolution over sustained wakefulness could be reversed by nasal continuous positive airway pressure (CPAP) therapy in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). ⋯ CPAP influences the EEG's time course over sustained wakefulness in a frequency-specific manner in OSAHS patients.
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Subcortical infarcts are most commonly the consequence of perforating artery occlusion and pure motor deficit is the most frequent syndrome resulting from an interruption of the corticospinal tract at the level of the corona radiate, the internal capsule or the brainstem. Motor evoked potential (MEP) monitoring is used as an adjunct to surgery as somatosensory evoked potentials (SEP) have been found to be insensitive to these lesions. Two different techniques have been used for monitoring MEPs during aneurysm surgery: transcranial electrical stimulation (TES) and direct cortical stimulation (DCS). ⋯ However, this technique also has disadvantages including subdural bleeding and injury to the brain. Using close-to-motor-threshold stimulation and focal stimulating electrode montages, TES and DCS MEPs do not vary significantly in their capacity to detect lesions of the motor cortex or its efferent pathways. Both techniques are prone to interference by anesthetic agents.
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The aim of this review is to present the status of electrodiagnostic standards and guidelines in neuromuscular disorders. Electrodiagnostic guidelines are developed on the background of medical technology assessment, wherefore a short presentation of medical technology assessment is given covering: (1) Evidence-based medicine, i.e. "to do the right thing", describing practice parameters and the STARD initiative which introduces evidence-based medicine in electrodiagnostic medicine, (2) Continuous quality improvement, i.e. "to do the thing right", describing variation among laboratories in methods and interpretation of tests, and the need for medical audit and implementation of electrodiagnostic guidelines, (3) Outcome studies, i.e. "is it worthwhile to do the right thing right?". In electrodiagnostic medicine there are very few outcome studies. ⋯ If no electrodiagnostic criteria for a given disorder exist, criteria for the electrodiagnostic examination are described if present. It is concluded that future research is needed in order to develop more electrodiagnostic guidelines in neuromuscular disorders by international expert consensus groups. Such research should use an evidence-based medicine approach and medical technology assessment and include continuous quality development and outcome studies.
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Comparative Study
Neurocognitive assessment and sleep analysis in children with sleep-disordered breathing.
To assess possible correlations between intelligence quotient (IQ) and attention deficit hyperactive disorder (ADHD) rating scale values and sleep (including cyclic alternating patterns analysis) and respiratory parameters in children with sleep-disordered breathing (SDB). ⋯ We believe that our study makes an interesting contribution to research on the relationship between sleep fragmentation and cognitive function.