Clinical EEG (electroencephalography)
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There is need nowadays to re-emphasize the capabilities of electroencephalography: a method representing the extremely important function/dysfunction-orientation in neurological thinking and practice. Valuable and relevant messages to the clinician naturally require solid EEG training and the resulting expertise. ⋯ The discussion of EEG and epileptology only skirts pediatric conditions (and most of the epileptic syndromes). It is shown that EEG reading in epileptology is a lot more than simply "hunting spikes." A strong plea is being made against the presently fashionable overuse of the term "non-convulsive status epilepticus." Continuing neglect of functional/dysfunctional orientation can seriously endanger the entire field of Neurology.
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Clin Electroencephalogr · Oct 1999
ReviewConsciousness as a definition of death: its appeal and complexity.
A new formulation of death proposed in this study is based on the basic physiopathological mechanisms of consciousness generation in human beings. Two physiological components control conscious behavior: arousal and awareness (content of consciousness). We cannot simply differentiate and locate arousal as a function of the ascending reticular activating system and awareness as a function of the cerebral cortex. ⋯ Therefore, consciousness does not bear a simple one-to-one relationship with higher or lower brain structures, because the physical substratum for consciousness is based on anatomy and physiology throughout the brain. This new account of human death is based on the irreversible loss of consciousness because it provides the key human attributes and the highest level of control in the hierarchy of integrating functions within the organism. The notion of consciousness as the ultimate integrative function is more consistent with the biologically-based systems than the more philosophically-based notions of personhood.
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Clin Electroencephalogr · Oct 1999
Quantitative EEG during early recovery from hypoxic-ischemic injury in immature piglets: burst occurrence and duration.
This study examined the course of EEG recovery in an animal model of hypoxic-ischemic injury. The model used periods of hypoxia, room air and asphyxia to induce cardiac arrest. One-week-old piglets (n = 16) were exposed to a period of hypoxia, room air and complete asphyxia for 7 minutes. ⋯ The critical determinant of the bursting character was the time when bursting occurred. Bursting occurring early in recovery was a good gauge of outcome. We conclude that quantitative EEG analysis and interpretation can be an important tool for the outcome determination during recovery from cerebral injury states.
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The burst-suppression (BS) pattern of the EEG occurs in a rather limited number of conditions. It has been observed in deep stages of general anesthesia and in conjunction with sedative overdoses. It is also known to occur in the wake of cardiorespiratory arrest. ⋯ Our personal interest was prompted by the consistent finding of BS activity in rats following cerebral anoxia (nitrogen inhalation, airway obstruction): after periods of EEG flatness, BS activity developed, followed by periodic bursts and diffuse slowing. On the other hand, earlier literature (before 1960) showed virtually no observation of BS, neither in anoxic patients, nor in animal experiments. It is likely that the introduction of modern intensive care treatment has engineered episodes of BS activity, probably due to modifications of the anoxic cerebral pathology.
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Clin Electroencephalogr · Apr 1999
QEEG changes during cardiopulmonary bypass: relationship to postoperative neuropsychological function.
The relationship of changes in intraoperative QEEG and postoperative cognitive function was studied in 32 patients undergoing cardiac surgical procedures requiring cardiopulmonary bypass (CPB). All patients were anesthetized with a high dose narcotic technique in which CPB was carried out using moderate hypothermia. EEG recorded continuously throughout each procedure was analyzed using the neurometric technique. ⋯ Discriminant analysis of the QEEG as a function of NP performance was calculated at select times during the surgical procedure. QEEG prediction of NP performance was just above chance at the 1 week comparison but excellent for the 2-3 month comparisons. This study suggests that with appropriate monitoring protocols, intraoperative QEEG may predict cognitive dysfunction experienced by patients 2-3 months postoperatively.