2020
Beyond implantation effect? Long-term seizure reduction and freedom following intracranial monitoring without additional surgical interventions
Percy J, Zaveri H, Duckrow RB, Gerrard J, Farooque P, Hirsch LJ, Spencer DD, Sivaraju A. Beyond implantation effect? Long-term seizure reduction and freedom following intracranial monitoring without additional surgical interventions. Epilepsy & Behavior 2020, 111: 107231. PMID: 32615416, DOI: 10.1016/j.yebeh.2020.107231.Peer-Reviewed Original ResearchConceptsLong-term seizure freedomSeizure freedomSeizure frequencyElectrode implantationIntracranial studiesLong-term seizure reductionAdditional surgical interventionSeizure onset localizationIntracranial electroencephalogram monitoringSeizure reductionConsecutive patientsSurgical interventionEpileptogenic networksElectroencephalogram monitoringNeuromodulatory effectsRetrospective analysisIntracranial monitoringTransient improvementDepth electrodesPatientsYear 4ImplantationAdequate dataYearsAssessment of the Validity of the 2HELPS2B Score for Inpatient Seizure Risk Prediction
Struck AF, Tabaeizadeh M, Schmitt SE, Ruiz AR, Swisher CB, Subramaniam T, Hernandez C, Kaleem S, Haider HA, Cissé AF, Dhakar MB, Hirsch LJ, Rosenthal ES, Zafar SF, Gaspard N, Westover MB. Assessment of the Validity of the 2HELPS2B Score for Inpatient Seizure Risk Prediction. JAMA Neurology 2020, 77: 500-507. PMID: 31930362, PMCID: PMC6990873, DOI: 10.1001/jamaneurol.2019.4656.Peer-Reviewed Original ResearchMeSH KeywordsAdultBrainElectroencephalographyFemaleHumansInpatientsMaleMiddle AgedMonitoring, PhysiologicRetrospective StudiesRisk AssessmentSeizuresConceptsContinuous electroencephalogramValidation cohortMAIN OUTCOMEEEG monitoringRetrospective medical record reviewKaplan-Meier survival analysisPatients 18 yearsMedical record reviewRisk of seizuresHigh-risk groupFirst hourEpileptiform EEG patternCEEG useClinical seizuresPrimary outcomeHospitalized patientsRecord reviewRisk stratificationEpileptiform findingsCardiac arrestSeizure riskClinical indicationsInclusion criteriaIndependent cohortAdequate screenValidation of the 2HELPS2B Seizure Risk Score in Acute Brain Injury Patients
Moffet EW, Subramaniam T, Hirsch LJ, Gilmore EJ, Lee JW, Rodriguez-Ruiz AA, Haider HA, Dhakar MB, Jadeja N, Osman G, Gaspard N, Struck AF. Validation of the 2HELPS2B Seizure Risk Score in Acute Brain Injury Patients. Neurocritical Care 2020, 33: 701-707. PMID: 32107733, DOI: 10.1007/s12028-020-00939-x.Peer-Reviewed Original ResearchConceptsAcute brain injuryClinical factorsContinuous EEG monitoringTraumatic brain injurySeizure incidenceEEG findingsClinical seizuresPrimary outcomeSubdural hematomaBrain injuryEEG monitoringAcute brain injury patientsRisk of seizuresBrain injury patientsReceiver operator characteristic curveOperator characteristic curveABI patientsPatient ageHospitalized patientsElectrographic seizuresInjury patientsIntraparenchymal hemorrhageClinical findingsSubarachnoid hemorrhageResultsA total
2019
Comparison of machine learning models for seizure prediction in hospitalized patients
Struck AF, Rodriguez‐Ruiz A, Osman G, Gilmore EJ, Haider HA, Dhakar MB, Schrettner M, Lee JW, Gaspard N, Hirsch LJ, Westover MB, Consortium C. Comparison of machine learning models for seizure prediction in hospitalized patients. Annals Of Clinical And Translational Neurology 2019, 6: 1239-1247. PMID: 31353866, PMCID: PMC6649418, DOI: 10.1002/acn3.50817.Peer-Reviewed Original ResearchConceptsLow-risk patientsNegative predictive valueEvaluation cohortContinuous EEGElastic net logistic regressionMulticenter databaseRisk stratificationSeizure riskPatientsPredictive valueComparable AUCSecondary analysisLogistic regressionCohortFirst hourSeizure predictionEEG recordingsEEGRisk calibrationLarge proportionSeizuresComplex neural networks
2018
Electro-clinical characteristics and prognostic significance of post anoxic myoclonus
Dhakar MB, Sivaraju A, Maciel CB, Youn TS, Gaspard N, Greer DM, Hirsch LJ, Gilmore EJ. Electro-clinical characteristics and prognostic significance of post anoxic myoclonus. Resuscitation 2018, 131: 114-120. PMID: 29964146, DOI: 10.1016/j.resuscitation.2018.06.030.Peer-Reviewed Original ResearchMeSH KeywordsAgedConsciousnessElectroencephalographyFemaleHeart ArrestHumansMaleMiddle AgedMonitoring, PhysiologicMyoclonusRetrospective StudiesTime FactorsWakefulnessConceptsPost-anoxic myoclonusRecovery of consciousnessElectro-clinical characteristicsComatose cardiac arrest survivorsLow voltage backgroundRetrospective chart reviewCardiac arrest survivorsElectro-clinical correlationsTime of dischargeContinuous EEG monitoringRelevant clinical variablesChart reviewHospital dischargeSpontaneous circulationArrest survivorsBrainstem reflexesCA survivorsPrognostic implicationsPrognostic significanceClinical variablesEEG findingsMyoclonusEEG monitoringPatientsLack of recovery
2017
Association of an Electroencephalography-Based Risk Score With Seizure Probability in Hospitalized Patients
Struck AF, Ustun B, Ruiz AR, Lee JW, LaRoche SM, Hirsch LJ, Gilmore EJ, Vlachy J, Haider HA, Rudin C, Westover MB. Association of an Electroencephalography-Based Risk Score With Seizure Probability in Hospitalized Patients. JAMA Neurology 2017, 74: 1419-1424. PMID: 29052706, PMCID: PMC5822188, DOI: 10.1001/jamaneurol.2017.2459.Peer-Reviewed Original ResearchConceptsIll patientsSeizure riskContinuous EEGRisk factorsMAIN OUTCOMEScoring systemBilateral independent periodic dischargesEpilepsy Monitoring Unit (EMU) admissionPeriodic dischargesBrief rhythmic dischargesProspective multicenter databaseSeizure risk factorsSporadic epileptiform dischargesRisk of seizuresRhythmic delta activitySimple scoring systemEligible patientsProbability of seizuresUnit admissionAcute illnessHospitalized patientsMulticenter databasePrior seizuresClinical historyClinical indications
2016
Development and Feasibility Testing of a Critical Care EEG Monitoring Database for Standardized Clinical Reporting and Multicenter Collaborative Research
Lee JW, LaRoche S, Choi H, Ruiz A, Fertig E, Politsky JM, Herman ST, Loddenkemper T, Sansevere AJ, Korb PJ, Abend NS, Goldstein JL, Sinha SR, Dombrowski KE, Ritzl EK, Westover MB, Gavvala JR, Gerard EE, Schmitt SE, Szaflarski JP, Ding K, Haas KF, Buchsbaum R, Hirsch LJ, Wusthoff CJ, Hopp JL, Hahn CD. Development and Feasibility Testing of a Critical Care EEG Monitoring Database for Standardized Clinical Reporting and Multicenter Collaborative Research. Journal Of Clinical Neurophysiology 2016, 33: 133-140. PMID: 26943901, PMCID: PMC4878836, DOI: 10.1097/wnp.0000000000000230.Peer-Reviewed Original ResearchConceptsCritical Care EEG Monitoring Research ConsortiumAmerican Clinical Neurophysiology SocietyIncidence of seizuresMulticenter feasibility studyIntensive care unitLarge-volume centersInterictal epileptiform dischargesDaily clinical useMulticenter collaborative researchCare unitUnique patientsVolume centersElectroencephalogram monitoringDuration of recordingEpileptiform dischargesMulticenter research studiesRhythmic dischargesClinical reportsResearch DatabaseEEG monitoringClinical data repositoryClinical useConsortium databaseEEG reportsReporting tools
2015
Human bedside evaluation versus automatic responsiveness testing in epilepsy (ARTiE)
Touloumes G, Morse E, Chen WC, Gober L, Dente J, Lilenbaum R, Katzenstein E, Pacelli A, Johnson E, Si Y, Sivaraju A, Grover E, Khozein R, Cunningham C, Hirsch LJ, Blumenfeld H. Human bedside evaluation versus automatic responsiveness testing in epilepsy (ARTiE). Epilepsia 2015, 57: e28-e32. PMID: 26663137, PMCID: PMC4707993, DOI: 10.1111/epi.13262.Peer-Reviewed Original ResearchMeSH KeywordsAdultDiagnosis, Computer-AssistedElectroencephalographyEpilepsyFemaleHumansMaleMental DisordersMonitoring, PhysiologicVideo RecordingYoung AdultConceptsVideo-EEG dataResponsiveness testingClinical careBehavioral testingInpatient video-electroencephalography (EEG) monitoringVideo-electroencephalography monitoringVideo-EEG monitoringAdditional clinical testingPediatric patientsEpilepsy centersPresurgical evaluationBedside evaluationClinical testingEpileptic seizuresBehavioral impairmentsSeizuresAccurate diagnosisNonmedical personnelPatient roomsEpilepsyBehavioral evaluationSeizure detectionBehavioral tasksMedical decisionsAutomatic seizure detectionPrognostication of post-cardiac arrest coma: early clinical and electroencephalographic predictors of outcome
Sivaraju A, Gilmore EJ, Wira CR, Stevens A, Rampal N, Moeller JJ, Greer DM, Hirsch LJ, Gaspard N. Prognostication of post-cardiac arrest coma: early clinical and electroencephalographic predictors of outcome. Intensive Care Medicine 2015, 41: 1264-1272. PMID: 25940963, DOI: 10.1007/s00134-015-3834-x.Peer-Reviewed Original ResearchConceptsBetter outcomesPoor outcomeEpileptiform dischargesPost-cardiac arrest comatose patientsCritical care EEG terminologyPost-cardiac arrest comaMethodsProspective cohort studyContinuous EEG monitoringLow-voltage EEGPositive predictive valueAbsence of reactivityEEG terminologyCohort studySpontaneous circulationBrainstem reflexesClinical outcomesComatose patientsFalse positive ratePoor prognosisPrognostic significanceSuppression burstsClinical variablesClinical correlatesElectroencephalographic patternsElectroencephalographic predictorsConsensus Statement on Continuous EEG in Critically Ill Adults and Children, Part I
Herman ST, Abend NS, Bleck TP, Chapman KE, Drislane FW, Emerson RG, Gerard EE, Hahn CD, Husain AM, Kaplan PW, LaRoche SM, Nuwer MR, Quigg M, Riviello JJ, Schmitt SE, Simmons LA, Tsuchida TN, Hirsch LJ. Consensus Statement on Continuous EEG in Critically Ill Adults and Children, Part I. Journal Of Clinical Neurophysiology 2015, 32: 87-95. PMID: 25626778, PMCID: PMC4435533, DOI: 10.1097/wnp.0000000000000166.Peer-Reviewed Original ResearchMeSH KeywordsAdultBrain DiseasesChildCritical CareCritical IllnessElectroencephalographyFemaleHumansMaleMonitoring, PhysiologicConceptsIll adultsConsensus panelStatus epilepticusPatient populationMental statusAmerican Clinical Neurophysiology SocietyContinuous EEGCritically Ill AdultsIdentification of ischemiaNonconvulsive status epilepticusIntensive care unitEfficacy of therapyQuantitative EEG trendsExpert consensus recommendationsCerebral ischemiaIntravenous sedationNonconvulsive seizuresCare unitSecondary injuryCardiac arrestConsensus statementConsensus recommendationsHigh riskEEG trendsPatientsConsensus Statement on Continuous EEG in Critically Ill Adults and Children, Part II
Herman ST, Abend NS, Bleck TP, Chapman KE, Drislane FW, Emerson RG, Gerard EE, Hahn CD, Husain AM, Kaplan PW, LaRoche SM, Nuwer MR, Quigg M, Riviello JJ, Schmitt SE, Simmons LA, Tsuchida TN, Hirsch LJ. Consensus Statement on Continuous EEG in Critically Ill Adults and Children, Part II. Journal Of Clinical Neurophysiology 2015, 32: 96-108. PMID: 25626777, PMCID: PMC4434600, DOI: 10.1097/wnp.0000000000000165.Peer-Reviewed Original ResearchMeSH KeywordsAdultBrain DiseasesChildCritical CareCritical IllnessElectroencephalographyFemaleHumansMaleMonitoring, PhysiologicConceptsIll adultsConsensus panelAmerican Clinical Neurophysiology SocietyContinuous EEGCritically Ill AdultsIntensive care unitNon-physician personnelExpert consensus recommendationsNeurodiagnostic technologistsQuantitative EEG techniquesCare unitPatient selectionPatient populationMental statusConsensus statementConsensus recommendationsInfection controlBrain functionCommon procedureEEGTask ForceAdultsEEG techniquesChildren
2013
Continuous electroencephalography in a surgical intensive care unit
Kurtz P, Gaspard N, Wahl AS, Bauer RM, Hirsch LJ, Wunsch H, Claassen J. Continuous electroencephalography in a surgical intensive care unit. Intensive Care Medicine 2013, 40: 228-234. PMID: 24240843, DOI: 10.1007/s00134-013-3149-8.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusPeriodic epileptiform dischargesNonconvulsive seizuresPoor outcomeClinical seizuresSICU patientsRetrospective studyCEEG monitoringMental statusSurgical intensive care unit patientsIntensive care unit patientsSurgical intensive care unitCare unit patientsContinuous electroencephalography monitoringMajority of patientsIntensive care unitMultivariable logistic regressionLiver transplantationHospital dischargeUnit patientsAbdominal surgeryPrimary outcomeStatus epilepticusCare unitMean age
2010
Is sudden unexpected death in epilepsy due to postictal brain shutdown?
Hirsch LJ. Is sudden unexpected death in epilepsy due to postictal brain shutdown? Annals Of Neurology 2010, 68: 773-775. PMID: 21194146, DOI: 10.1002/ana.22242.Peer-Reviewed Original ResearchAnimalsBrainDeath, SuddenElectroencephalographyEpilepsyHumansInfantMonitoring, PhysiologicSudden Infant DeathIntracortical EEG for the Detection of Vasospasm in Patients with Poor-Grade Subarachnoid Hemorrhage
Stuart RM, Waziri A, Weintraub D, Schmidt MJ, Fernandez L, Helbok R, Kurtz P, Lee K, Badjatia N, Emerson R, Mayer SA, Connolly ES, Hirsch LJ, Claassen J. Intracortical EEG for the Detection of Vasospasm in Patients with Poor-Grade Subarachnoid Hemorrhage. Neurocritical Care 2010, 13: 355-358. PMID: 20652443, DOI: 10.1007/s12028-010-9414-6.Peer-Reviewed Original ResearchConceptsPoor-grade SAH patientsAlpha/delta ratioDetection of vasospasmSAH patientsPoor-grade subarachnoid hemorrhageIntracortical electroencephalographyQuantitative EEG parametersQuantitative EEG analysisAngiographic confirmationAngiographic vasospasmSubarachnoid hemorrhageSustained decreaseVasospasmPatientsBaseline EEGPercent changeDepth electrodesQEEG recordingsLarger studySurface EEGDelta ratioIntracortical EEGEEG parametersAlarm criteriaBaselineUse of EEG Monitoring and Management of Non-Convulsive Seizures in Critically Ill Patients: A Survey of Neurologists
Abend NS, Dlugos DJ, Hahn CD, Hirsch LJ, Herman ST. Use of EEG Monitoring and Management of Non-Convulsive Seizures in Critically Ill Patients: A Survey of Neurologists. Neurocritical Care 2010, 12: 382-389. PMID: 20198513, PMCID: PMC2944658, DOI: 10.1007/s12028-010-9337-2.Peer-Reviewed Original ResearchConceptsNon-convulsive seizuresIll patientsEEG monitoringPhenytoin/fosphenytoinCritically Ill PatientsAbnormal eye movementsFurther prospective studiesCommon clinical problemSurvey of neurologistsCEEG indicationsCEEG utilizationResultsThree hundredStatus epilepticusProspective studyMental statusCommon anticonvulsantsClinical problemPatientsAreas of uncertaintyPrior convulsionsCurrent practiceEye movementsLevetiracetamSeizuresNeurologistsIntracranial Multimodal Monitoring for Acute Brain Injury: A Single Institution Review of Current Practices
Stuart RM, Schmidt M, Kurtz P, Waziri A, Helbok R, Mayer SA, Lee K, Badjatia N, Hirsch LJ, Connolly ES, Claassen J. Intracranial Multimodal Monitoring for Acute Brain Injury: A Single Institution Review of Current Practices. Neurocritical Care 2010, 12: 188-198. PMID: 20107926, DOI: 10.1007/s12028-010-9330-9.Peer-Reviewed Original ResearchConceptsAcute brain injuryBrain injurySevere acute brain injuryNeurological intensive care unitInsertion techniqueSecondary brain injuryDay of admissionMethodsSixty-one patientsRate of hematomaSingle-institution reviewIntensive care unitBrain tissue oxygenCerebral blood flowFocal brain injuryMultimodality brain monitoringPatient-specific selectionInvasive monitoring devicesHospital lengthFrequent complicationNICU lengthPatient demographicsCare unitMultimodality monitoringConsecutive seriesInstitution review
2009
Continuous Electroencephalogram Monitoring in the Intensive Care Unit
Friedman D, Claassen J, Hirsch LJ. Continuous Electroencephalogram Monitoring in the Intensive Care Unit. Anesthesia & Analgesia 2009, 109: 506-523. PMID: 19608827, DOI: 10.1213/ane.0b013e3181a9d8b5.Peer-Reviewed Original ResearchConceptsContinuous EEG monitoringNonconvulsive seizuresIll patientsIntracranial pressureBrain functionContinuous electroencephalogram monitoringConvulsive status epilepticusIntensive care unitMajority of seizuresMultimodality brain monitoringPharmacological comaNeurologic outcomeNeurologic statusNeuronal injuryBrain ischemiaStatus epilepticusCare unitSecondary injurySubarachnoid hemorrhageCEEG monitoringClinical examinationElectroencephalogram monitoringSystemic abnormalitiesIntracranial EEG recordingsHigh riskHow Long Does It Take to Make an Accurate Diagnosis in an Epilepsy Monitoring Unit?
Friedman DE, Hirsch LJ. How Long Does It Take to Make an Accurate Diagnosis in an Epilepsy Monitoring Unit? Journal Of Clinical Neurophysiology 2009, 26: 213-217. PMID: 19584746, DOI: 10.1097/wnp.0b013e3181b2f2da.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overElectroencephalographyEpilepsyFemaleHumansInpatientsMaleMiddle AgedMonitoring, PhysiologicRetrospective StudiesTimeVideo RecordingYoung AdultConceptsInterictal epileptiform dischargesEpilepsy monitoring unitDefinite epilepsyNonepileptic eventsEpileptic seizuresEpileptiform dischargesAccurate diagnosisMore daysPercent of patientsConsecutive adult patientsExistence of patientsAdult patientsInterictal electroencephalographyMedian timeRetrospective reviewPresurgical evaluation
2008
Continuous Electroencephalographic Monitoring in Critically Ill Patients With Central Nervous System Infections
Carrera E, Claassen J, Oddo M, Emerson RG, Mayer SA, Hirsch LJ. Continuous Electroencephalographic Monitoring in Critically Ill Patients With Central Nervous System Infections. JAMA Neurology 2008, 65: 1612-1618. PMID: 19064748, DOI: 10.1001/archneur.65.12.1612.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedCentral Nervous System InfectionsChi-Square DistributionCohort StudiesCritical IllnessElectroencephalographyFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedMonitoring, PhysiologicRetrospective StudiesSeizuresStatistics, NonparametricX-Ray MicrotomographyYoung AdultConceptsCentral nervous system infectionNervous system infectionPeriodic epileptiform dischargesContinuous electroencephalographic monitoringElectrographic seizuresSystem infectionElectroencephalographic monitoringIll patientsPoor outcomeClinical correlatesEpileptiform dischargesPrimary central nervous system infectionCritically Ill PatientsRetrospective cohort studyNeurocritical care unitElectrographic findingsCohort studyConsecutive patientsCare unitViral causeClinical significancePatientsMonitoring findingsInfectionAdditional studies
2007
Cyclic electrographic seizures in critically ill patients
Friedman DE, Schevon C, Emerson RG, Hirsch LJ. Cyclic electrographic seizures in critically ill patients. Epilepsia 2007, 49: 281-287. PMID: 17900293, DOI: 10.1111/j.1528-1167.2007.01327.x.Peer-Reviewed Original ResearchConceptsCyclic seizuresIll patientsPattern of seizuresStandard EEG recordingsNonconvulsive seizuresStatus epilepticusElectrographic seizuresSeizure activityUnderlying pathophysiologyElectroencephalographic monitoringSeizure initiationEEG frequency spectrumPatientsSeizuresContinuous EEGEEG powerPathophysiologyEEG recordingsCsAEpilepticusCessation