2022
Developing a Standardized Approach to Grading the Level of Brain Dysfunction on EEG
Dhakar MB, Sheikh ZB, Desai M, Desai RA, Sternberg EJ, Popescu C, Baron-Lee J, Rampal N, Hirsch LJ, Gilmore EJ, Maciel CB. Developing a Standardized Approach to Grading the Level of Brain Dysfunction on EEG. Journal Of Clinical Neurophysiology 2022, 40: 553-561. PMID: 35239553, DOI: 10.1097/wnp.0000000000000919.Peer-Reviewed Original ResearchConceptsCerebral dysfunctionCritical Care EEG Monitoring Research ConsortiumInterrater agreementGrading scaleStandardized approachDegree of dysfunctionKappa statisticsStandardized grading scalePosterior dominant rhythmElectroencephalogram (EEG) background activityLevel of dysfunctionOverall interrater agreementNeuromonitoring toolsFleiss kappa statisticEEG findingsBrain dysfunction
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 abnormalities
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 analysisEEGMorbidityValidation 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
Continuous EEG Findings in Autoimmune Encephalitis.
Moise AM, Karakis I, Herlopian A, Dhakar M, Hirsch LJ, Cotsonis G, LaRoche S, Cabrera Kang CM, Westover B, Rodriguez A. Continuous EEG Findings in Autoimmune Encephalitis. Journal Of Clinical Neurophysiology 2019, 38: 124-129. PMID: 31800465, PMCID: PMC7263965, DOI: 10.1097/wnp.0000000000000654.Peer-Reviewed Original ResearchConceptsNew-onset refractory status epilepticusRefractory status epilepticusRhythmic delta activityGeneralized rhythmic delta activityAutoimmune encephalitisStatus epilepticusDelta activityPoor outcomeAE subtypeFast activityAntibody-negative autoimmune encephalitisN-methyl-D-aspartate receptorsDefinite limbic encephalitisExtreme delta brushMulticenter retrospective reviewNew-onset seizuresContinuous EEG monitoringGlutamic acid decarboxylaseVoltage-gated potassium channelsLimbic encephalitisRetrospective reviewAE patientsElectrographic seizuresDelta brushEEG findings
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 recoveryClinical Correlates of Periodic Discharges and Nonconvulsive Seizures in Posterior Reversible Encephalopathy Syndrome (PRES)
Bastide L, Legros B, Rampal N, Gilmore EJ, Hirsch LJ, Gaspard N. Clinical Correlates of Periodic Discharges and Nonconvulsive Seizures in Posterior Reversible Encephalopathy Syndrome (PRES). Neurocritical Care 2018, 29: 481-490. PMID: 29949000, DOI: 10.1007/s12028-018-0548-2.Peer-Reviewed Original ResearchConceptsPosterior reversible encephalopathy syndromeReversible encephalopathy syndromeContinuous electroencephalography monitoringGlasgow Outcome ScaleNonconvulsive seizuresPeriodic dischargesEncephalopathy syndromeRisk factorsWorse outcomesEpileptiform patternsMagnetic resonance imaging (MRI) abnormalitiesRetrospective cohort studyCEEG findingsEligible patientsRelated seizuresCohort studyHospital dischargeLow disabilityIll patientsImaging abnormalitiesMedical chartsClinical featuresPathophysiological mechanismsEEG findingsFunctional outcome
2017
Time‐dependent risk of seizures in critically ill patients on continuous electroencephalogram
Struck AF, Osman G, Rampal N, Biswal S, Legros B, Hirsch LJ, Westover MB, Gaspard N. Time‐dependent risk of seizures in critically ill patients on continuous electroencephalogram. Annals Of Neurology 2017, 82: 177-185. PMID: 28681492, PMCID: PMC5842678, DOI: 10.1002/ana.24985.Peer-Reviewed Original ResearchConceptsEpileptiform EEG abnormalitiesClinical factorsIll patientsEpileptiform findingsRisk factorsEEG abnormalitiesEEG risk factorsClinical risk factorsRisk of seizuresHistory of seizuresPresence of comaDuration of monitoringGreater predictive valueTime-dependent riskAnn NeurolSeizure incidenceAcute illnessPrior seizuresClinical variablesEEG findingsProspective dataSeizure riskBaseline riskMultistate survival modelsPredictive value
2012
Extreme delta brush
Schmitt SE, Pargeon K, Frechette ES, Hirsch LJ, Dalmau J, Friedman D. Extreme delta brush. Neurology 2012, 79: 1094-1100. PMID: 22933737, PMCID: PMC3525298, DOI: 10.1212/wnl.0b013e3182698cd8.Peer-Reviewed Original ResearchConceptsExtreme delta brushAnti-NMDAR encephalitisDelta brushCEEG monitoringAdult patientsAnti-NMDA receptor encephalitisExtreme delta brush patternModified Rankin Scale scoreRankin Scale scoreLarge academic medical centerAcademic medical centerContinuous EEG patternReceptor encephalitisPremature infantsProlonged hospitalizationCommon symptomsMedian lengthEEG findingsElectrographic patternsProlonged illnessMovement disordersMedical CenterPatientsScale scoreEncephalitis
2008
Focal motor seizures induced by alerting stimuli in critically ill patients
Hirsch LJ, Pang T, Claassen J, Chang C, Khaled KA, Wittman J, Emerson RG. Focal motor seizures induced by alerting stimuli in critically ill patients. Epilepsia 2008, 49: 968-973. PMID: 18177364, DOI: 10.1111/j.1528-1167.2007.01481.x.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAnticonvulsantsArousalBrain Damage, ChronicBrain StemChildCritical CareDominance, CerebralElectroencephalographyEpilepsy, Partial, MotorEpilepsy, ReflexFemaleFrontal LobeHumansMagnetic Resonance ImagingMaleMiddle AgedRisk FactorsSubstance Withdrawal SyndromeTemporal LobeThalamusVideo RecordingConceptsFocal motor seizuresMotor seizuresIll patientsEEG findingsTertiary care medical centerVideo-EEG findingsNonconvulsive status epilepticusReview of chartsElectrographic seizure activityFocal EEG findingsArousal circuitryHyperexcitable cortexEncephalopathic patientsAcute illnessClinical seizuresStatus epilepticusBilateral thalamusComatose patientsElectrographic seizuresUpper brainstemSeizure activityClinical correlatesEpileptiform activityMotor pathwaysNeurological ICU
2006
Prognostic significance of continuous EEG monitoring in patients with poor-grade subarachnoid hemorrhage
Claassen J, Hirsch LJ, Frontera JA, Fernandez A, Schmidt M, Kapinos G, Wittman J, Connolly ES, Emerson RG, Mayer SA. Prognostic significance of continuous EEG monitoring in patients with poor-grade subarachnoid hemorrhage. Neurocritical Care 2006, 4: 103-112. PMID: 16627897, DOI: 10.1385/ncc:4:2:103.Peer-Reviewed Original ResearchConceptsModified Rankin ScalePeriodic lateralized epileptiform dischargesSubarachnoid hemorrhageHess gradePoor outcomeEEG findingsCEEG monitoringEpileptiform dischargesPoor-grade subarachnoid hemorrhageMultivariate logistic regression analysisAdmission CT scanPeriodic epileptiform dischargesLogistic regression analysisRankin ScaleIll patientsIntraventricular hemorrhageMRS 4Functional outcomeSleep architectureEEG reactivityCT scanPatientsOutcomesHemorrhageRegression analysis