Clinical EEG (electroencephalography)
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Clin Electroencephalogr · Apr 1999
Middle latency auditory evoked potentials during total intravenous anesthesia with droperidol, ketamine and fentanyl.
We investigated whether total intravenous anesthesia with ketamine, fentanyl and droperidol would affect middle latency auditory evoked potentials and explicit memory, and whether dreams during the anesthesia are related to plasma concentrations of fentanyl and the infusion technique. A total number of 40 patients were the subjects for this study. Twenty patients (group A) were maintained with intravenous ketamine 2 mg kg-1 hr-1 and fentanyl 5 micrograms kg-1 hr-1 for the first 60 min and 3 micrograms kg-1 hr-1 for the next 90 min, and droperidol 0.1 mg kg-1. ⋯ Plasma fentanyl levels of group B patients were significantly lower than those of group A patients and the incidence of the dreams was significantly higher in group B patients. We conclude that the anesthesia with ketamine, fentanyl and droperidol is not associated with the explicit memories, though the middle latency auditory evoked potentials were not significantly changed as compared with those in the waking state. In addition, dreams during the anesthesia may correlate with plasma fentanyl concentrations or the infusion technique.
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Clin Electroencephalogr · Jan 1999
Case ReportsProgression of electroclinical changes in complex partial status epilepticus: filling in the blanks.
Treiman has described five electroclinical stages through which the EEG progresses during generalized convulsive status epilepticus (GCSE). The EEG can show similar patterns in patients with complex partial status epilepticus (CPSE), but there is no agreement as to whether the different patterns seen in the human EEG result from a similar orderly progression through similar stages. We report the case of a patient in CPSE whose EEG passed progressively through two of the earlier stages described by Treiman. This case of EEG progression in a single patient suggests that CPSE can progress through stages analogous to those in GCSE.
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Clin Electroencephalogr · Jan 1999
Case ReportsIntravenous valproate treatment of generalized nonconvulsive status epilepticus.
Status Epilepticus (SE) is a medical emergency warranting prompt treatment with rapidly-acting antiepileptic drugs. For immediate effect, benzodiazepines are the drugs of choice, but may result in morbidity due to respiratory suppression and hypotension. Nonconvulsive status epilepticus usually does not have significant neurological sequelae, and there is little evidence that generalized nonconvulsive status epilepticus (GNSE) causes lasting neurologic deficits. ⋯ Following intravenous valproate given during EEG monitoring, GNSE broke after 30 minutes. The confused patient returned to a normal cognition and returned home without sequelae. Intravenous valproate may provide an effective treatment alternative to benzodiazepines in GNSE without their associated morbidity.
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Clin Electroencephalogr · Apr 1997
QEEG and neuropsychological profiles of patients after undergoing cardiopulmonary bypass surgical procedures.
One week after surgery neuropsychological (NP) deficits were quite common, occurring in 40.6% of the patients, with QEEG abnormality developing or increasing in the majority of patients. This change in the QEEG was an accurate predictor of NP performance 1 week after surgery. Two to three months after surgery evidence of continued NP performance deficits were still present in 28.1% of the patients. ⋯ The mean values of specificity plus sensitivity were 74.5% for NP performance and 89.1% for the QEEG. These high levels of sensitivity and specificity for QEEG change for predicting postoperative cognitive function may justify the utility of performing these evaluations in the general CPB surgical population. In addition, this evidence supports the need to study the role of intraoperative QEEG monitoring to determine when QEEG change occurs so that possible remediational measures can be taken as soon as possible.
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Clin Electroencephalogr · Apr 1997
QEEG and neuropsychological profiles of patients prior to undergoing cardiopulmonary bypass surgical procedures.
Within our patient population undergoing cardiopulmonary bypass (CPB) surgery, evidence of pre-existing cortical dysfunction was highly prevalent, with 39.5% displaying QEEG and/or neuropsychological (NP) abnormality. These patients with pre-existing QEEG or NP abnormality were at increased risk for developing both short and long-term postoperative deficits in NP performance. ⋯ Two to three months after surgery evidence of continued NP performance deficits were still present in 28.1% of the patients. Preoperative NP performance predicted 3 month postoperative NP performance quite well, although preoperative QEEG proved equally effective.