2021
High epileptiform discharge burden predicts delayed cerebral ischemia after subarachnoid hemorrhage
Kim JA, Zheng WL, Elmer J, Jing J, Zafar SF, Ghanta M, Moura V, Gilmore EJ, Hirsch LJ, Patel A, Rosenthal E, Westover MB. High epileptiform discharge burden predicts delayed cerebral ischemia after subarachnoid hemorrhage. Clinical Neurophysiology 2021, 141: 139-146. PMID: 33812771, PMCID: PMC8429508, DOI: 10.1016/j.clinph.2021.01.022.Peer-Reviewed Original ResearchMeSH KeywordsBrain IschemiaCerebral InfarctionHumansPeriodicityRetrospective StudiesSubarachnoid HemorrhageConceptsED burdenSubarachnoid hemorrhageEpileptiform dischargesCerebral ischemiaSAH patientsHigh riskOnset of DCIMajor risk periodContinuous EEG recordingsDCI patientsDCI riskRetrospective analysisNovel biomarkersGroup-based trajectory analysisRisk periodPatientsDay 3.5DCIBurdenHemorrhageIschemiaRiskEEG recordingsBurden rateUseful parameter
2018
Bilateral independent periodic discharges are associated with electrographic seizures and poor outcome: A case-control study
Osman G, Rahangdale R, Britton JW, Gilmore EJ, Haider HA, Hantus S, Herlopian A, Hocker SE, Woo Lee J, Legros B, Mendoza M, Punia V, Rampal N, Szaflarski JP, Wallace AD, Westover MB, Hirsch LJ, Gaspard N. Bilateral independent periodic discharges are associated with electrographic seizures and poor outcome: A case-control study. Clinical Neurophysiology 2018, 129: 2284-2289. PMID: 30227348, PMCID: PMC6785981, DOI: 10.1016/j.clinph.2018.07.025.Peer-Reviewed Original ResearchConceptsBilateral independent periodic dischargesCase-control studyElectrographic seizuresPoor outcomePeriodic dischargesLPD groupBrain injuryRetrospective case-control studyAcute brain injuryAnoxic brain injuryCNS infectionsFrequent etiologyCerebral injuryIll patientsClinical managementPD groupLevel of alertnessHigh riskBetter outcomesPatientsMultivariate analysisSeizuresInjuryPotential important implicationsOutcomesDefinition and Classification of Periodic and Rhythmic Patterns
Maciel CB, Hirsch LJ. Definition and Classification of Periodic and Rhythmic Patterns. Journal Of Clinical Neurophysiology 2018, 35: 179-188. PMID: 29718827, DOI: 10.1097/wnp.0000000000000462.Peer-Reviewed Original ResearchMeSH KeywordsBrainCritical CareElectroencephalographyHumansNervous System DiseasesPeriodicityTerminology as TopicConceptsAmerican Clinical Neurophysiology SocietyContinuous video-EEG recordingOverall clinical implicationsAcute brain injuryRhythmic delta activityVideo-EEG recordingsEpileptogenic potentialTherapeutic algorithmAbnormal findingsNonconvulsive seizuresComatose patientsBrain injuryClinical indicationsInpatient settingDelta activityClinical implicationsMorphologic featuresPeriodic dischargesStandardized definitionsPatientsPrevalence of occurrenceDefinitive evidenceExcellent temporal resolutionIschemia detectionOfficial guidelines
2017
Brief Potentially Ictal Rhythmic Discharges [B(I)RDs] in Noncritically Ill Adults
Yoo JY, Marcuse LV, Fields MC, Rosengard JL, Traversa MV, Gaspard N, Hirsch LJ. Brief Potentially Ictal Rhythmic Discharges [B(I)RDs] in Noncritically Ill Adults. Journal Of Clinical Neurophysiology 2017, 34: 222-229. PMID: 28463933, DOI: 10.1097/wnp.0000000000000357.Peer-Reviewed Original ResearchConceptsIctal rhythmic dischargesIll adultsRhythmic dischargesSeizure onset areaAdult patientsElectrographic characteristicsStatus epilepticusAcute findingsIll patientsRefractory epilepsyClinical historySeizure onsetClinical significanceEpileptiform dischargesAmbulatory settingPatientsBenign patternControl groupEpilepsyRhythmic activityOnset areaAlpha activityAdultsBrief runsEEG recordingsAssociation of Periodic and Rhythmic Electroencephalographic Patterns With Seizures in Critically Ill Patients
Ruiz A, Vlachy J, Lee JW, Gilmore EJ, Ayer T, Haider HA, Gaspard N, Ehrenberg JA, Tolchin B, Fantaneanu TA, Fernandez A, Hirsch LJ, LaRoche S. Association of Periodic and Rhythmic Electroencephalographic Patterns With Seizures in Critically Ill Patients. JAMA Neurology 2017, 74: 181-188. PMID: 27992625, DOI: 10.1001/jamaneurol.2016.4990.Peer-Reviewed Original ResearchMeSH KeywordsBrain WavesCohort StudiesCritical IllnessElectroencephalographyFemaleHumansMalePeriodicitySeizuresConceptsRhythmic delta activityDelta activityPeriodic dischargesIll patientsSeizure riskElectroencephalographic patternsStimulation-induced patternsCritically Ill PatientsRisk of seizuresHigher seizure riskAcademic medical centerFrequency-dependent mannerSeizure incidenceIll adultsRisk stratificationHigh prevalenceMedical CenterMAIN OUTCOMEContinuous electroencephalographySeizuresPattern prevalenceMultivariate analysisPatientsClinical decisionRhythmic patternsCyclic seizures in critically ill patients: Clinical correlates, DC recordings and outcomes
Pinto LF, Gilmore EJ, Petroff OA, Sivaraju A, Rampal N, Hirsch LJ, Gaspard N. Cyclic seizures in critically ill patients: Clinical correlates, DC recordings and outcomes. Clinical Neurophysiology 2017, 128: 1083-1090. PMID: 28214108, DOI: 10.1016/j.clinph.2017.01.015.Peer-Reviewed Original ResearchConceptsCyclic seizuresProgressive brain injuryStatus epilepticusIll patientsClinical correlatesBrain injuryDC recordingsNon-convulsive status epilepticusEEG baselineNonconvulsive status epilepticusOlder patientsElectrographic seizuresWorse prognosisFocal onsetPoor outcomePrognostic significanceSeizure initiationPatientsInfraslow activitySeizuresCommon formEpilepticusFurther studiesPosterior regionInjury
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
2014
Brief Rhythmic Discharges in Electroencephalography on an Interictal to Ictal Continuum—Reply
Gaspard N, Yoo JY, Hirsch LJ. Brief Rhythmic Discharges in Electroencephalography on an Interictal to Ictal Continuum—Reply. JAMA Neurology 2014, 71: 1193-1194. PMID: 25200548, DOI: 10.1001/jamaneurol.2014.1865.Peer-Reviewed Original ResearchBrief Potentially Ictal Rhythmic Discharges in Critically Ill Adults
Yoo JY, Rampal N, Petroff OA, Hirsch LJ, Gaspard N. Brief Potentially Ictal Rhythmic Discharges in Critically Ill Adults. JAMA Neurology 2014, 71: 454-462. PMID: 24535702, DOI: 10.1001/jamaneurol.2013.6238.Peer-Reviewed Original ResearchConceptsIctal rhythmic dischargesRhythmic dischargesIll patientsContinuous electroencephalographyCritically Ill AdultsPrevalence of seizuresGlasgow Outcome ScaleLarge prospective studiesSingle focal lesionCerebral injuryIll adultsElectrographic seizuresPrognostic significanceProspective studyFunctional outcomeSubclinical seizuresOutcome ScalePrimary diagnosisWorse outcomesHigh prevalenceEarly predictorMAIN OUTCOMEFocal lesionsPatientsSeizures
2013
Similarity of Lateralized Rhythmic Delta Activity to Periodic Lateralized Epileptiform Discharges in Critically Ill Patients
Gaspard N, Manganas L, Rampal N, Petroff OA, Hirsch LJ. Similarity of Lateralized Rhythmic Delta Activity to Periodic Lateralized Epileptiform Discharges in Critically Ill Patients. JAMA Neurology 2013, 70: 1288-1295. PMID: 23921464, DOI: 10.1001/jamaneurol.2013.3475.Peer-Reviewed Original ResearchConceptsLateralized rhythmic delta activityRhythmic delta activityContinuous EEG monitoringIll patientsDelta activityPeriodic dischargesAcute seizuresClinical significanceIll subjectsEEG monitoringEEG patternsPeriodic lateralized epileptiform dischargesJuxtacortical white matterContinuous electroencephalography monitoringIntensive care unitCross-sectional prevalenceFocal EEG abnormalitiesAcademic medical centerSimilar clinical significanceRadiological correlatesEarly seizuresMost patientsAcute illnessDischarge groupIndependent predictors
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
2005
Which EEG Patterns Warrant Treatment in the Critically Ill? Reviewing the Evidence for Treatment of Periodic Epileptiform Discharges and Related Patterns
Chong DJ, Hirsch LJ. Which EEG Patterns Warrant Treatment in the Critically Ill? Reviewing the Evidence for Treatment of Periodic Epileptiform Discharges and Related Patterns. Journal Of Clinical Neurophysiology 2005, 22: 79-91. PMID: 15805807, DOI: 10.1097/01.wnp.0000158699.78529.af.Peer-Reviewed Original ResearchConceptsNonconvulsive seizuresPeriodic dischargesContinuous electroencephalographic monitoringPeriodic epileptiform dischargesCritically IllNeuronal injuryIll patientsElectrographic patternsElectroencephalographic monitoringEpileptiform dischargesClinical settingEEG patternsCurrent criteriaSeizuresTreatmentManagement recommendationsDischargePatientsEtiologyInjuryDiagnosisThe ACNS Subcommittee on Research Terminology for Continuous EEG Monitoring: Proposed Standardized Terminology for Rhythmic and Periodic EEG Patterns Encountered in Critically Ill Patients
Hirsch LJ, Brenner RP, Drislane FW, So E, Kaplan PW, Jordan KG, Herman ST, LaRoche SM, Young B, Bleck TP, Scheuer ML, Emerson RG. The ACNS Subcommittee on Research Terminology for Continuous EEG Monitoring: Proposed Standardized Terminology for Rhythmic and Periodic EEG Patterns Encountered in Critically Ill Patients. Journal Of Clinical Neurophysiology 2005, 22: 128-135. PMID: 15805813, DOI: 10.1097/01.wnp.0000158701.89576.4c.Peer-Reviewed Original Research