2025
Management and Outcomes in Confirmed or Suspected Acute Symptomatic Seizure: Role of Structured Outpatient Care
Punia V, Byrnes M, Thompson N, Ayub N, Rubinos C, Zafar S, Sivaraju A, Ying Z, Fesler J, Hantus S, investigators P. Management and Outcomes in Confirmed or Suspected Acute Symptomatic Seizure: Role of Structured Outpatient Care. Annals Of Clinical And Translational Neurology 2025, 12: 1225-1239. PMID: 40244869, PMCID: PMC12172096, DOI: 10.1002/acn3.70039.Peer-Reviewed Original ResearchConceptsAcute symptomatic seizuresSymptomatic seizuresUnprovoked seizuresASyS patientsEpileptiform abnormalitiesMedian 14-month follow-upContinuous EEGRetrospective study of adultsCox proportional hazards modelsCause-specific Cox proportional hazards modelsProportional hazards modelRisk of unprovoked seizuresOutpatient EEGAlive patientsStudy of adultsOutpatient careSingle-centerRetrospective studyFollow-upPatientsCumulative incidence functionHazards modelSeizuresPost-discharge managementAbnormalities
2024
Antiseizure Medication Use and Outcomes After Suspected or Confirmed Acute Symptomatic Seizures
Zafar S, Sivaraju A, Rubinos C, Ayub N, Awodutire P, McKee Z, Chandan P, Byrnes M, Bhansali S, Rice H, Smith-Ayala A, Haider M, Tveter E, Erlich-Malona N, Ibanhes F, DeMarco A, Lewis S, Dhakar M, Punia V. Antiseizure Medication Use and Outcomes After Suspected or Confirmed Acute Symptomatic Seizures. JAMA Neurology 2024, 81: 1159-1169. PMID: 39312247, PMCID: PMC11420826, DOI: 10.1001/jamaneurol.2024.3189.Peer-Reviewed Original ResearchAssociated with increased oddsAcute symptomatic seizuresAntiseizure medication treatmentDischarge prescriptionsSymptomatic seizuresAntiseizure medicationsElectrographic seizuresContinuous electroencephalographyOdds of treatmentGlasgow Outcome Scale scoreNeurological intensive care unitOptimal treatment durationMulticenter cohort studyAntiseizure medication useOutcome Scale scorePrescribed antiseizure medicationsAssociated with functional outcomeIntensive care unitAssociated with outcomeMain OutcomesProgressive brain injuryASM treatmentMedication useCohort studyEpileptiform abnormalitiesPredictors 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 unitImmediate and long‐term management practices of acute symptomatic seizures and epileptiform abnormalities: A cross‐sectional international survey
Punia V, Daruvala S, Dhakar M, Zafar S, Rubinos C, Ayub N, Hirsch L, Sivaraju A, investigators F. Immediate and long‐term management practices of acute symptomatic seizures and epileptiform abnormalities: A cross‐sectional international survey. Epilepsia 2024, 65: 909-919. PMID: 38358383, DOI: 10.1111/epi.17915.Peer-Reviewed Original ResearchAnti-seizure medicationsEpileptiform abnormalitiesAcute symptomatic seizuresAcute brain injuryContinuous EEGSecondary prophylaxisSymptomatic seizuresSporadic epileptiform dischargesLateralized periodic dischargesCross-sectional international surveyOutpatient follow-upAnti-seizure medication useOptimal care pathwayDose escalationBrain injuryDose changesLong-term managementElectrographic seizuresEpileptiform dischargesFollow-upAncillary testsReal-world practiceRecommended durationContinuous electroencephalographyHospital discharge
2023
Do acute EEG findings add to clinical features in predicting outcomes after status epilepticus and acute symptomatic seizures?
Sivaraju A, Hirsch L. Do acute EEG findings add to clinical features in predicting outcomes after status epilepticus and acute symptomatic seizures? Epilepsy & Behavior 2023, 141: 109134. PMID: 36848748, DOI: 10.1016/j.yebeh.2023.109134.Peer-Reviewed Original ResearchConceptsAcute symptomatic seizuresAnti-seizure medicationsStatus epilepticusEEG findingsSymptomatic seizuresSeizure clinicFunctional outcomeClinical careLong-term clinical careLife-threatening medical emergencyAcute EEG findingsLondon-Innsbruck ColloquiumSubsequent unprovoked seizuresPoor functional outcomeContinuous EEG monitoringAcute seizuresNonconvulsive seizuresClinical featuresPediatric populationUnprovoked seizuresEpileptiform abnormalitiesEpileptic patternsSpecialty clinicTreatment strategiesPrognostic accuracy
2022
Electroencephalography at the height of a pandemic: EEG findings in patients with COVID-19
Tantillo G, Jetté N, Gururangan K, Agarwal P, Marcuse L, Singh A, Goldstein J, Kwon C, Dhamoon M, Navis A, Nadkarni G, Charney A, Young J, Blank L, Fields M, Yoo J. Electroencephalography at the height of a pandemic: EEG findings in patients with COVID-19. Clinical Neurophysiology 2022, 137: 102-112. PMID: 35305494, PMCID: PMC8901228, DOI: 10.1016/j.clinph.2022.03.001.Peer-Reviewed Original ResearchConceptsCOVID-19 patientsHospitalized COVID-19 patientsSeizure risk factorsSevere COVID-19VEEG findingsRisk factorsMost COVID-19 patientsCOVID-19New York City hospitalsRetrospective chart reviewAcute cerebral injurySeizure-like movementsVEEG monitoringCerebral injuryChart reviewCritical illnessElectroencephalogram findingsRenal failureHemorrhagic strokeEEG findingsEpileptiform abnormalitiesCity HospitalPatientsSharp wavesPeriodic dischargesAcute 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
Electroencephalographic Abnormalities are Common in COVID‐19 and are Associated with Outcomes
Lin L, Al‐Faraj A, Ayub N, Bravo P, Das S, Ferlini L, Karakis I, Lee JW, Mukerji SS, Newey CR, Pathmanathan J, Abdennadher M, Casassa C, Gaspard N, Goldenholz DM, Gilmore EJ, Jing J, Kim JA, Kimchi EY, Ladha HS, Tobochnik S, Zafar S, Hirsch LJ, Westover MB, Shafi MM. Electroencephalographic Abnormalities are Common in COVID‐19 and are Associated with Outcomes. Annals Of Neurology 2021, 89: 872-883. PMID: 33704826, PMCID: PMC8104061, DOI: 10.1002/ana.26060.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusElectrographic seizuresClinical outcomesEpileptiform abnormalitiesRisk factorsPresence of NCSEMultivariate Cox proportional hazards analysisMulticenter retrospective cohort studyCox proportional hazards analysisCOVID-19Retrospective cohort studyClinical risk factorsContinuous electroencephalogram monitoringAdverse clinical outcomesProportional hazards analysisCoronavirus disease 2019Ann NeurolHospital mortalityHospital lengthClinical seizuresCohort studyIndependent predictorsStatus epilepticusEEG findingsElectroencephalographic abnormalitiesElectroencephalography, Hospital Complications, and Longitudinal Outcomes After Subarachnoid Hemorrhage
Lissak IA, Locascio JJ, Zafar SF, Schleicher RL, Patel AB, Leslie-Mazwi T, Stapleton CJ, Koch MJ, Kim JA, Anderson K, Rosand J, Westover MB, Kimberly WT, Rosenthal ES. Electroencephalography, Hospital Complications, and Longitudinal Outcomes After Subarachnoid Hemorrhage. Neurocritical Care 2021, 35: 397-408. PMID: 33483913, PMCID: PMC7822587, DOI: 10.1007/s12028-020-01177-x.Peer-Reviewed Original ResearchConceptsHospital-acquired infectionsHospital complicationsEpileptiform abnormalitiesSubarachnoid hemorrhageCerebral ischemiaLongitudinal outcomesContinuous EEGNon-traumatic subarachnoid hemorrhageTime pointsNontraumatic subarachnoid hemorrhageEffects modelCumulative proportional odds modelRankin ScaleProspective studyFunctional outcomeResultsIn totalBaseline severityCEEG monitoringTherapeutic targetComplicationsSustained impairmentMRS assessmentSecondary analysisLongitudinal assessmentMixed effects models
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 analysisEEGMorbiditySoluble ST2 Is Associated With New Epileptiform Abnormalities Following Nontraumatic Subarachnoid Hemorrhage
Lissak IA, Zafar SF, Westover MB, Schleicher RL, Kim JA, Leslie-Mazwi T, Stapleton CJ, Patel AB, Kimberly WT, Rosenthal ES. Soluble ST2 Is Associated With New Epileptiform Abnormalities Following Nontraumatic Subarachnoid Hemorrhage. Stroke 2020, 51: 1128-1134. PMID: 32156203, PMCID: PMC7123848, DOI: 10.1161/strokeaha.119.028515.Peer-Reviewed Original ResearchConceptsPlasma sST2 levelsSoluble ST2Epileptiform abnormalitiesNontraumatic subarachnoid hemorrhageSubarachnoid hemorrhageSST2 levelsNeurophysiologic changesCerebral ischemiaIL-6Continuous electroencephalographyMeasures mixed-effects modelsInnate immune response pathwaysAdmission risk factorsPlasma soluble ST2Secondary brain injurySubgroup of patientsSubarachnoid hemorrhage patientsSerial plasma samplesAssociation of biomarkersInnate immune responseWilcoxon rank sum testImmune response pathwaysMixed-effects modelingRank sum testInflammatory biomarkers
2018
Effect of epileptiform abnormality burden on neurologic outcome and antiepileptic drug management after subarachnoid hemorrhage
Zafar SF, Postma EN, Biswal S, Boyle EJ, Bechek S, O'Connor K, Shenoy A, Kim J, Shafi MS, Patel AB, Rosenthal ES, Westover MB. Effect of epileptiform abnormality burden on neurologic outcome and antiepileptic drug management after subarachnoid hemorrhage. Clinical Neurophysiology 2018, 129: 2219-2227. PMID: 30212805, PMCID: PMC6478499, DOI: 10.1016/j.clinph.2018.08.015.Peer-Reviewed Original ResearchConceptsAnti-epileptic drugsAneurysmal subarachnoid hemorrhageEpileptiform abnormalitiesWorse outcomesSubarachnoid hemorrhageHigh-grade aSAH patientsEvidence-based treatment protocolsGlasgow Outcome ScoreAntiepileptic drug managementStandard prophylaxisNeurologic outcomeProphylactic protocolASAH patientsOutcome scoresDrug managementHigh burdenRetrospective analysisTreatment protocolOutcome measuresPatientsDaily burdenRhythmic activityFirst dayOutcomesBurden
2017
Epileptiform abnormalities predict delayed cerebral ischemia in subarachnoid hemorrhage
Kim JA, Rosenthal ES, Biswal S, Zafar S, Shenoy AV, O'Connor KL, Bechek SC, Moura J, Shafi MM, Patel AB, Cash SS, Westover MB. Epileptiform abnormalities predict delayed cerebral ischemia in subarachnoid hemorrhage. Clinical Neurophysiology 2017, 128: 1091-1099. PMID: 28258936, PMCID: PMC5476529, DOI: 10.1016/j.clinph.2017.01.016.Peer-Reviewed Original ResearchConceptsCerebral ischemiaSubarachnoid hemorrhageRisk of DCISecondary cerebral injuryRhythmic delta activityAbnormal neural activityNew potential targetsCerebral injuryEarly patientsEpileptiform abnormalitiesMedical recordsEpileptiform dischargesRetrospective analysisHigh riskDCI developmentDelta activityPatientsNovel markerIschemiaSurvival analysis methodsCumulative probabilityPotential targetNeural activityNew markersDCI
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