2025
Incidence of Concurrent Cerebral Desaturation and Electroencephalographic Burst Suppression in Cardiac Surgery Patients
Ramachandran R, Behera A, Hussain Z, Peck J, Ananthakrishanan A, Mathur P, Banner-Goodspeed V, Muehlschlegel J, Pittet J, Bardia A, Schonberger R, Marcantonio E, Kveraga K, Subramaniam B. Incidence of Concurrent Cerebral Desaturation and Electroencephalographic Burst Suppression in Cardiac Surgery Patients. Anesthesia & Analgesia 2025, 140: 1086-1092. PMID: 39446661, PMCID: PMC11996613, DOI: 10.1213/ane.0000000000007209.Peer-Reviewed Original ResearchCerebral desaturationAortic cross-clampingCardiac surgeryPost-CPBBurst suppressionCross-clampingRemoval of aortic cross-clampCerebral oximetryAssociated with postoperative deliriumPhase of cardiac surgeryCardiac surgery patientsElectroencephalographic burst suppressionConfidence intervalsIntraoperative burst suppressionPostoperative cognitive functionPre-CPBPrecardiopulmonary bypassSurgery patientsEntire surgeryEEG monitoringPostoperative deliriumTargeted interventionsOdds ratioSurgerySurgical phaseAdherence to Recommendations and Yield of Critical Care EEG Monitoring: A Prospective Multicentric Study.
Bellante F, Santos S, Gérard L, Jacquet L, Piagnerelli M, Taccone F, Thooft A, Wittebole X, Legros B, Gaspard N. Adherence to Recommendations and Yield of Critical Care EEG Monitoring: A Prospective Multicentric Study. Journal Of Clinical Neurophysiology 2025 PMID: 39810297, DOI: 10.1097/wnp.0000000000001143.Peer-Reviewed Original ResearchGroup of patientsAcute brain injuryClinical seizuresElectrographic seizuresStatus epilepticusClinical factorsEEG monitoringSociety recommendationsMulticenter prospective observational studySeizure riskAmerican Clinical Neurophysiology SocietyMental statusCritically ill adult patientsRefractory status epilepticusConvulsive status epilepticusProspective multicentre studyDetection of electrographic seizuresIll adult patientsLow-risk groupIntensive care unitTime of dischargeBrain injuryPrimary admission diagnosisPatient selectionAdult patients
2024
Parallel electrophysiological abnormalities due to COVID‐19 infection and to Alzheimer's disease and related dementia
Jiang Y, Neal J, Sompol P, Yener G, Arakaki X, Norris C, Farina F, Ibanez A, Lopez S, Al‐Ezzi A, Kavcic V, Güntekin B, Babiloni C, Hajós M. Parallel electrophysiological abnormalities due to COVID‐19 infection and to Alzheimer's disease and related dementia. Alzheimer's & Dementia 2024, 20: 7296-7319. PMID: 39206795, PMCID: PMC11485397, DOI: 10.1002/alz.14089.Peer-Reviewed Original ResearchCOVID-19 patientsEEG abnormalitiesNeurophysiological abnormalitiesMild cognitive impairmentCognitive deficitsBrain activityAstrocyte reactivityPredicting long-term outcomesCognitive impairmentLong-term outcomesSlowing of EEGCognitive declineEfficacy of therapeutic interventionsIntrinsic brain activityLong COVIDElectrophysiological brain activityEEG slowingNeurological complicationsEpileptiform activityEEG monitoringEarly stages of neurodegenerative diseasesCognitive decline riskNeurovascular injuryLong COVID-19Acute phasePredictors of follow-up care for critically-ill patients with seizures and epileptiform abnormalities on EEG monitoring
Rice H, Fernandes M, Punia V, Rubinos C, Sivaraju A, Zafar S. Predictors of follow-up care for critically-ill patients with seizures and epileptiform abnormalities on EEG monitoring. Clinical Neurology And Neurosurgery 2024, 241: 108275. PMID: 38640778, PMCID: PMC11167629, DOI: 10.1016/j.clineuro.2024.108275.Peer-Reviewed Original ResearchConceptsNeurological follow-upFollow-up visitFollow-upAntiseizure medicationsOutpatient follow-upCritically-ill patientsContinuous EEGEpileptiform abnormalitiesPredictors of follow-upPrevent long-term complicationsIllness severityYounger ageRetrospective cohort studyLong-term complicationsFollow-up statusIntensive care unitProbability of follow-upHigher illness severityPredictors of readmissionContinuous EEG recordingsRisk stratificationEEG monitoringCohort studyCritically-illCare unitProvider Experience With the Use of Ketamine for Refractory Status Epilepticus
Tantillo G, Davis N, Granstein J, Yoo J, Agarwal P, Reilly K, Reynolds A, Kayal G, Liang J, Jetté N. Provider Experience With the Use of Ketamine for Refractory Status Epilepticus. Clinical Neuropharmacology 2024, 47: 37-43. PMID: 38478363, DOI: 10.1097/wnf.0000000000000582.Peer-Reviewed Original ResearchConceptsRefractory status epilepticusStatus epilepticusPerceived contraindicationsUse of vasopressorsFirst-line agentsRefractory status epilepticus treatmentSecond-line agentsAssociated with complicationsElevated intracranial pressureNeurocritical Care SocietyRespiratory depressionHeart failureEEG monitoringHemodynamic supportOptimal doseKetamine useSeizure controlIntracranial pressureControl seizuresDecreased needKetamine usersAmerican Epilepsy SocietyKetamineAmerican AcademyAnesthetic agents
2022
Electroencephalogram in the intensive care unit: a focused look at acute brain injury
Alkhachroum A, Appavu B, Egawa S, Foreman B, Gaspard N, Gilmore EJ, Hirsch LJ, Kurtz P, Lambrecq V, Kromm J, Vespa P, Zafar SF, Rohaut B, Claassen J. Electroencephalogram in the intensive care unit: a focused look at acute brain injury. Intensive Care Medicine 2022, 48: 1443-1462. PMID: 35997792, PMCID: PMC10008537, DOI: 10.1007/s00134-022-06854-3.Peer-Reviewed Original ResearchConceptsAcute brain injuryNonconvulsive status epilepticusBrain injuryStatus epilepticusEEG monitoringIntensive care unit settingRefractory status epilepticusSecondary brain injuryIntensive care unitPossible clinical relevanceAssessment of consciousnessResource-limited settingsICU EEG monitoringFrequent seizuresAcute illnessCommon indicationCare unitWorse outcomesUnit settingClinical relevancePathophysiological eventsSeizure criteriaIschemia monitoringInjuryApplication of electroencephalographyAcute epileptiform abnormalities are the primary predictors of post‐stroke epilepsy: a matched, case–control study
Punia V, Ellison L, Bena J, Chandan P, Sivaraju A, George P, Newey CR, Hantus S. Acute epileptiform abnormalities are the primary predictors of post‐stroke epilepsy: a matched, case–control study. Annals Of Clinical And Translational Neurology 2022, 9: 558-563. PMID: 35243824, PMCID: PMC8994977, DOI: 10.1002/acn3.51534.Peer-Reviewed Original ResearchConceptsPost-stroke epilepsyDays of presentationMultivariable logistic modelCase-control studyContinuous EEG monitoringUnivariable analysisStroke patientsEpileptiform abnormalitiesSeizure managementPresence of EAEEG monitoringTherapy trialsEpilepsyPrimary predictorPredictorsLogistic modelPatientsAbnormalitiesTrials
2021
Passive Localization of the Central Sulcus during Sleep Based on Intracranial EEG
Alkawadri R, Zaveri HP, Sheth KN, Spencer DD. Passive Localization of the Central Sulcus during Sleep Based on Intracranial EEG. Cerebral Cortex 2021, 32: 3726-3735. PMID: 34921723, PMCID: PMC9764437, DOI: 10.1093/cercor/bhab443.Peer-Reviewed Original ResearchConceptsCentral sulcusMotor cortexMotor areaLeg motor areaPrimary motor cortexIntracranial EEG monitoringTongue motor areaLocal network activityMotor/premotorSM cortexIntractable epilepsySensorimotor cortexAnterior bankNREM sleepSensory cortexEEG monitoringZ-scoreHigher EEGCortexIntracranial EEGSignificant differencesPatientsSleepNetwork activityPrimary handProcessed intraoperative burst suppression and postoperative cognitive dysfunction in a cohort of older noncardiac surgery patients
Dustin Boone M, Lin H, Liu X, Kim J, Sano M, Baxter M, Sieber F, Deiner S. Processed intraoperative burst suppression and postoperative cognitive dysfunction in a cohort of older noncardiac surgery patients. Journal Of Clinical Monitoring And Computing 2021, 36: 1433-1440. PMID: 34862586, DOI: 10.1007/s10877-021-00783-0.Peer-Reviewed Original ResearchConceptsPostoperative cognitive dysfunctionIntraoperative burst suppressionNoncardiac surgery patientsSurgery patientsBurst suppressionEEG monitoringAssociated with postoperative cognitive dysfunctionCognitive dysfunctionZ-scoreBaseline z-scoresIntraoperative anesthetic managementReduced alpha-band powerPreventing postoperative cognitive dysfunctionProspective cohort studyClinical trial numberPeriods of electrical silenceElective surgery patientsYears of ageDetect burst suppressionProcessed EEG monitoringPreoperative baselineBurst suppression ratioHigh-voltage activityOlder age groupsComposite z-score
2020
Detecting Seizures and Epileptiform Abnormalities in Acute Brain Injury
Singla S, Garcia GE, Rovenolt GE, Soto AL, Gilmore EJ, Hirsch LJ, Blumenfeld H, Sheth KN, Omay SB, Struck AF, Westover MB, Kim JA. Detecting Seizures and Epileptiform Abnormalities in Acute Brain Injury. Current Neurology And Neuroscience Reports 2020, 20: 42. PMID: 32715371, PMCID: PMC9353690, DOI: 10.1007/s11910-020-01060-4.Peer-Reviewed Original ResearchConceptsIctal-interictal continuumBrain injuryAcute brain injuryBetter clinical outcomesTraumatic brain injuryRecent FindingsCurrent literatureIncreased morbidityClinical outcomesEpileptiform abnormalitiesEEG findingsMortality riskEEG monitoringEpileptiform patternsPrognostic modelSeizuresClinical settingInjuryLogistical barriersElectroencephalogram studyUse of EEGABIPractical barriersEEG analysisEEGMorbidityAssessment 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 ResearchConceptsContinuous 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 totalMesial temporal resection following long‐term ambulatory intracranial EEG monitoring with a direct brain‐responsive neurostimulation system
Hirsch LJ, Mirro EA, Salanova V, Witt TC, Drees CN, Brown M, Lee RW, Sadler TL, Felton EA, Rutecki P, Shin HW, Hadar E, Hegde M, Rao VR, Mnatsakanyan L, Madhavan DS, Zakaria TJ, Liu AA, Heck CN, Greenwood JE, Bigelow JK, Nair DR, Alexopoulos AV, Mackow M, Edwards JC, Sotudeh N, Kuzniecky RI, Gwinn RP, Doherty MJ, Geller EB, Morrell MJ. Mesial temporal resection following long‐term ambulatory intracranial EEG monitoring with a direct brain‐responsive neurostimulation system. Epilepsia 2020, 61: 408-420. PMID: 32072621, PMCID: PMC7154711, DOI: 10.1111/epi.16442.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnterior Temporal LobectomyDrug Resistant EpilepsyElectric Stimulation TherapyElectrocorticographyEpilepsy, Temporal LobeFemaleHumansImplantable NeurostimulatorsMaleMiddle AgedMonitoring, AmbulatoryNeurosurgical ProceduresRetrospective StudiesTemporal LobeTreatment OutcomeYoung AdultConceptsMTL resectionElectrographic seizuresTemporal lobe seizure onsetClinical seizure reductionMesial temporal resectionIntracranial EEG monitoringRNS SystemBitemporal epilepsySeizure reductionSeizure outcomeTemporal resectionPrimary outcomeRefractory epilepsyAdditional patientsEpilepsy centersUnilateral onsetBilateral onsetIcEEG recordingsSeizure onsetMTL epilepsyMedian reductionResectionPatientsEEG monitoringIcEEG data
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 ResearchConceptsPost-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
(Invited) Conjoint Measurement of Brain Electrophysiology and Neurochemistry
Zaveri H, Ganesh N, Goncharova I, Damisah E, Ong C, Perez E, Staib L, Hirsch L, Petroff O, Spencer D, Eid T. (Invited) Conjoint Measurement of Brain Electrophysiology and Neurochemistry. ECS Meeting Abstracts 2017, MA2017-02: 2329-2329. DOI: 10.1149/ma2017-02/55/2329.Peer-Reviewed Original ResearchInterictal EEG spikesBasal glutamateBrain excitabilityIntractable epilepsyEEG spikesBrain electrophysiologySpike rateBasal extracellular glutamate concentrationsIntracranial EEG monitoringExtracellular glutamate concentrationCo-localized measurementsPossible epilepsy surgeryBrain extracellular glutamateInterictal electroencephalographyMicrodialysis catheterEpilepsy surgeryExtracellular glutamateBrain neurochemistryDialysis probeNeurochemical basisEEG monitoringGlutamate concentrationBrain regionsEpilepsyPatientsThe use and yield of continuous EEG in critically ill patients: A comparative study of three centers
Alvarez V, Ruiz A, LaRoche S, Hirsch LJ, Parres C, Voinescu PE, Fernandez A, Petroff OA, Rampal N, Haider HA, Lee JW, Consortium T. The use and yield of continuous EEG in critically ill patients: A comparative study of three centers. Clinical Neurophysiology 2017, 128: 570-578. PMID: 28231475, DOI: 10.1016/j.clinph.2017.01.001.Peer-Reviewed Original ResearchConceptsHigh-volume centersIll patientsVolume centersDoses of levetiracetamTertiary care sitesContinuous EEG monitoringDetection rateCEEG useSeizure frequencyFirst seizureMedian timeSeizure detection rateCEEG monitoringRecent guidelinesPatient managementCare sitesValproic acidASD useEEG monitoringDrug usageContinuous EEGSignificant differencesPatientsReporting toolsCEEG
2016
The relationship between seizures, interictal spikes and antiepileptic drugs
Goncharova II, Alkawadri R, Gaspard N, Duckrow RB, Spencer DD, Hirsch LJ, Spencer SS, Zaveri HP. The relationship between seizures, interictal spikes and antiepileptic drugs. Clinical Neurophysiology 2016, 127: 3180-3186. PMID: 27292227, DOI: 10.1016/j.clinph.2016.05.014.Peer-Reviewed Original ResearchConceptsFirst seizureSeizure occurrenceAED taperSpike rateEEG monitoringMarker of inhibitionIntracranial EEG monitoringOccurrence of seizuresScalp EEG monitoringConsecutive patientsAntiepileptic drugsDrug taperHigh spike ratesInterictal spikesSeizuresDay 4Intracranial electrodesPatientsAEDsSignificant relationshipDevelopment 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 toolsProgressive change in sleep over multiple nights of intracranial EEG monitoring
Joshi RB, Gaspard N, Goncharova II, Pavlova M, Duckrow RB, Gerrard JL, Spencer DD, Hirsch LJ, Zaveri HP. Progressive change in sleep over multiple nights of intracranial EEG monitoring. Clinical Neurophysiology 2016, 127: 2302-2307. PMID: 27072103, DOI: 10.1016/j.clinph.2016.02.018.Peer-Reviewed Original Research
2015
Clinical Correlates and Prognostic Significance of Lateralized Periodic Discharges in Patients Without Acute or Progressive Brain Injury
Sainju RK, Manganas LN, Gilmore EJ, Petroff OA, Rampal N, Hirsch LJ, Gaspard N. Clinical Correlates and Prognostic Significance of Lateralized Periodic Discharges in Patients Without Acute or Progressive Brain Injury. Journal Of Clinical Neurophysiology 2015, 32: 495-500. PMID: 26200591, DOI: 10.1097/wnp.0000000000000206.Peer-Reviewed Original ResearchConceptsProgressive brain injuryAcute brain injuryBrain injuryAbnormal consciousnessPeriodic dischargesClinical correlatesFunctional declineLateralized periodic dischargesRemote brain injuryOutcomes of patientsCase-control studyContinuous EEG monitoringHistory of epilepsyRadiologic evidenceHospital dischargeStatus epilepticusWorse prognosisAcute injuryPrognostic significanceWorse outcomesEEG monitoringMultivariate analysisInjuryPatientsLower likelihood
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