2021
Video quality using outpatient smartphone videos in epilepsy: Results from the OSmartViE study
Tatum WO, Hirsch LJ, Gelfand MA, Acton EK, LaFrance WC, Duckrow RB, Chen D, Blum AS, Hixson J, Drazkowski J, Benbadis S, Cascino GD, Collaborators T. Video quality using outpatient smartphone videos in epilepsy: Results from the OSmartViE study. European Journal Of Neurology 2021, 28: 1453-1462. PMID: 33465822, DOI: 10.1111/ene.14744.Peer-Reviewed Original ResearchMeSH KeywordsAdultCohort StudiesElectroencephalographyEpilepsyFemaleHumansMiddle AgedOutpatientsProspective StudiesSmartphoneConceptsPsychogenic nonepileptic attacksNeurologic eventsEpileptic seizuresInpatient video-electroencephalography (EEG) monitoringPhysiologic nonepileptic eventsMulticenter cohort studyMajority of patientsVideo-electroencephalography monitoringVideo-EEG monitoringSimilar diagnostic accuracyHome video recordingEpilepsy outpatientsNeurological disease statesCohort studyNeurological eventsNonepileptic eventsNonepileptic attacksUnknown diagnosisAdequate durationClinical informationPatientsSenior neurology residentsAccurate diagnosisDiagnostic accuracyNeurology residents
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 networksAdherence with psychotherapy and treatment outcomes for psychogenic nonepileptic seizures.
Tolchin B, Dworetzky BA, Martino S, Blumenfeld H, Hirsch LJ, Baslet G. Adherence with psychotherapy and treatment outcomes for psychogenic nonepileptic seizures. Neurology 2019, 92: e675-e679. PMID: 30610097, PMCID: PMC6382361, DOI: 10.1212/wnl.0000000000006848.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAdult Survivors of Child AbuseAgedAged, 80 and overCohort StudiesConversion DisorderEmergency Service, HospitalEthnicityFemaleFollow-Up StudiesHumansMaleMiddle AgedMinority GroupsOdds RatioProspective StudiesPsychotherapyQuality of LifeSeizuresTreatment Adherence and ComplianceTreatment OutcomeYoung AdultConceptsPsychogenic nonepileptic seizuresQuality of lifePNES frequencyNonepileptic seizuresProspective cohort studyEmergency department utilizationTime of referralBaseline characteristicsCohort studyED visitsSeizure frequencyED utilizationPotential confoundersWomen's HospitalTreatment outcomesMedium effect sizeLocal therapistsMultivariate modelAdherenceChildhood abuseSeizuresHospitalSignificant reductionOutcomesEffect size
2017
Association 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 patterns
2016
Drug‐resistant epilepsy in adults: Outcome trajectories after failure of two medications
Choi H, Hayat MJ, Zhang R, Hirsch LJ, Bazil CW, Mendiratta A, Kato K, Javed A, Legge AW, Buchsbaum R, Resor S, Heiman GA. Drug‐resistant epilepsy in adults: Outcome trajectories after failure of two medications. Epilepsia 2016, 57: 1152-1160. PMID: 27265407, DOI: 10.1111/epi.13406.Peer-Reviewed Original ResearchConceptsDrug-resistant epilepsySeizure freedomAntiepileptic drugsAdult patientsEpilepsy typeFocal epilepsyContinuous seizure freedomThird antiepileptic drugTertiary epilepsy centerSeizure-free periodMultiple ordinal logistic regression modelsLogistic regression modelsOrdinal logistic regression modelsClinical factorsIndependent predictorsEpilepsy centersMedical managementFluctuating courseOccipital lobeTemporal lobeEligibility criteriaPatientsEpilepsyTrajectory outcomesOutcome trajectoriesThe 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 relationship
2015
New-onset refractory status epilepticus
Gaspard N, Foreman BP, Alvarez V, Cabrera Kang C, Probasco JC, Jongeling AC, Meyers E, Espinera A, Haas KF, Schmitt SE, Gerard EE, Gofton T, Kaplan PW, Lee JW, Legros B, Szaflarski JP, Westover BM, LaRoche SM, Hirsch LJ, Fertig E, Herman S, Huh L, Lee J, Loddenkemper T, Chapman K, Abend N, Carpenter J, Hantus S, Claassen J, Husain A, Gaspard N, LaRoche S, Ritzl E, Gofton T, Wusthoff C, Goldstein J, Westover B, Hocker S, Halford J, Jones J, Gerard E, Schmitt S, Williams K, Hahn C, Szaflarski J, Kramer A, Rudzinski L, Hopp J, Mani R, Kalamangalam G, Gupta P, Quigg M, Haas K, Ostendorf A, Zutshi D, Hirsch L. New-onset refractory status epilepticus. Neurology 2015, 85: 1604-1613. PMID: 26296517, PMCID: PMC4642147, DOI: 10.1212/wnl.0000000000001940.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAnestheticsAnti-N-Methyl-D-Aspartate Receptor EncephalitisAnticonvulsantsAutoantibodiesCohort StudiesEncephalitisEncephalitis, Herpes SimplexFemaleHashimoto DiseaseHumansLength of StayMaleMiddle AgedParaneoplastic Syndromes, Nervous SystemPotassium Channels, Voltage-GatedPrognosisRetrospective StudiesStatus EpilepticusTime FactorsTreatment OutcomeYoung AdultConceptsNew-onset refractory status epilepticusRefractory status epilepticusStatus epilepticusPoor outcomeTherapy warrants further investigationInflammatory CSF changesHours of admissionPrimary outcome measurePoor functional outcomePredictors of outcomeAcademic medical centerWarrants further investigationUse of anestheticsRole of anestheticsAutoimmune encephalitisAntiseizure medicationsCryptogenic casesParaneoplastic encephalitisMedical complicationsRetrospective reviewAvailable followClinical featuresImmune therapyFunctional outcomeFunctional statusGeneralized periodic discharges and ‘triphasic waves’: A blinded evaluation of inter-rater agreement and clinical significance
Foreman B, Mahulikar A, Tadi P, Claassen J, Szaflarski J, Halford JJ, Dean BC, Kaplan PW, Hirsch LJ, LaRoche S, Consortium C. Generalized periodic discharges and ‘triphasic waves’: A blinded evaluation of inter-rater agreement and clinical significance. Clinical Neurophysiology 2015, 127: 1073-1080. PMID: 26294138, DOI: 10.1016/j.clinph.2015.07.018.Peer-Reviewed Original ResearchConceptsTriphasic wavesClinical EEG interpretationInter-rater agreementCritical care EEG terminologyPeriodic dischargesToxic-metabolic encephalopathyPatient informationContinuous EEG monitoringSpecific clinical conditionsEEG interpretationEEG terminologyMetabolic encephalopathiesNonconvulsive seizuresClinical significanceBlinded evaluationClinical conditionsSimilar riskEEG monitoringSeizuresConsistency of usePatientsEncephalopathyEEG descriptorsAssociationDescriptive termsRates and predictors of patient-reported cognitive side effects of antiepileptic drugs: An extended follow-up
Javed A, Cohen B, Detyniecki K, Hirsch LJ, Legge A, Chen B, Bazil C, Kato K, Buchsbaum R, Choi H. Rates and predictors of patient-reported cognitive side effects of antiepileptic drugs: An extended follow-up. Seizure 2015, 29: 34-40. PMID: 26076842, DOI: 10.1016/j.seizure.2015.03.013.Peer-Reviewed Original ResearchConceptsCognitive side effectsAntiepileptic medicationsSide effectsMultiple logistic regression analysisMore antiepileptic medicationsLogistic regression analysisQuality of lifeIndependent predictorsRetrospective studyAntiepileptic drugsAdult outpatientsMedical recordsAdverse effectsIntellectual disabilityPolytherapyLevetiracetamGabapentinRegression analysisLamotrigineLower ratesPredictorsCarbamazepineMonotherapyMedicationsRelative frequency
2013
High-dose midazolam infusion for refractory status epilepticus
Fernandez A, Lantigua H, Lesch C, Shao B, Foreman B, Schmidt JM, Hirsch LJ, Mayer SA, Claassen J. High-dose midazolam infusion for refractory status epilepticus. Neurology 2013, 82: 359-365. PMID: 24363133, PMCID: PMC3929199, DOI: 10.1212/wnl.0000000000000054.Peer-Reviewed Original ResearchConceptsHigh-dose groupRefractory status epilepticusLow-dose groupStatus epilepticusLower mortalityHigh-dose midazolam infusionLower seizure ratesStatus epilepticus onsetClass III evidenceLow-dose protocolHigher infusion ratesHospital complicationsHospital courseSeizure recurrenceBaseline characteristicsSeizure controlWithdrawal seizuresMedian timeDischarge mortalityMidazolam dosesMidazolam infusionSeizure rateWorse outcomesTreatment protocolInfusion rate
2012
Prospective assessment of ictal behavior using the revised Responsiveness in Epilepsy Scale (RES-II)
Bauerschmidt A, Koshkelashvili N, Ezeani CC, Yoo JY, Zhang Y, Manganas LN, Kapadia K, Palenzuela D, Schmidt C, Lief R, Kiely BT, Choezom T, McClurkin M, Shorten A, Detyniecki K, Hirsch LJ, Giacino JT, Blumenfeld H. Prospective assessment of ictal behavior using the revised Responsiveness in Epilepsy Scale (RES-II). Epilepsy & Behavior 2012, 26: 25-28. PMID: 23201609, PMCID: PMC3741052, DOI: 10.1016/j.yebeh.2012.10.022.Peer-Reviewed Original Research
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
Generalized convulsive status epilepticus after nontraumatic subarachnoid hemorrhage: the nationwide inpatient sample.
Claassen J, Bateman BT, Willey JZ, Inati S, Hirsch LJ, Mayer SA, Sacco RL, Schumacher HC. Generalized convulsive status epilepticus after nontraumatic subarachnoid hemorrhage: the nationwide inpatient sample. Neurosurgery 2007, 61: 60-4; discussion 64-5. PMID: 17621019, DOI: 10.1227/01.neu.0000279724.05898.e7.Peer-Reviewed Original ResearchConceptsNontraumatic subarachnoid hemorrhageConvulsive status epilepticusNationwide Inpatient SampleSubarachnoid hemorrhageRenal diseaseStatus epilepticusInpatient SampleNonfederal United States hospitalsGeneralized convulsive status epilepticusDatabase of admissionsDuration of hospitalizationMultivariate logistic regressionUnited States hospitalsHospital mortalityHospital stayAdult patientsYounger patientsIndependent predictorsPatient mortalityEmergency departmentPatientsLinear regression analysisState HospitalNeurosurgical proceduresLogistic regressionConvulsive status epilepticus after ischemic stroke and intracerebral hemorrhage: frequency, predictors, and impact on outcome in a large administrative dataset
Bateman BT, Claassen J, Willey JZ, Hirsch LJ, Mayer SA, Sacco RL, Schumacher HC. Convulsive status epilepticus after ischemic stroke and intracerebral hemorrhage: frequency, predictors, and impact on outcome in a large administrative dataset. Neurocritical Care 2007, 7: 187-193. PMID: 17503112, DOI: 10.1007/s12028-007-0056-2.Peer-Reviewed Original ResearchConceptsAcute ischemic strokeConvulsive status epilepticusIntracerebral hemorrhageIschemic strokeICH cohortRenal diseaseStatus epilepticusSodium imbalanceAlcohol abuseAIS cohortDiagnosis of AISAppropriate ICD-9-CM codesICD-9-CM codesHigh rateNationwide Inpatient SampleAfrican American raceMultivariate logistic regressionLower ratesResultsThe cohortHemorrhagic transformationDiabetes mellitusHemorrhagic strokeIndependent predictorsSerious complicationsHispanic race
2006
Frequency and Predictors of Nonconvulsive Seizures During Continuous Electroencephalographic Monitoring in Critically Ill Children
Jette N, Claassen J, Emerson RG, Hirsch LJ. Frequency and Predictors of Nonconvulsive Seizures During Continuous Electroencephalographic Monitoring in Critically Ill Children. JAMA Neurology 2006, 63: 1750-1755. PMID: 17172615, DOI: 10.1001/archneur.63.12.1750.Peer-Reviewed Original ResearchConceptsContinuous electroencephalographic monitoringPeriodic lateralized epileptiform dischargesNonconvulsive seizuresIll childrenElectroencephalographic monitoringEpileptiform dischargesMultivariate logistic regression analysisMajority of patientsLogistic regression analysisAbsence of reactivityCEEG initiationClinical seizuresStatus epilepticusPrior seizuresSeizuresMultivariate analysisFirst hourChildrenPatientsRegression analysisBackground reactivityHoursPredictorsHours of recordingsEpilepticusPrognostic 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
2004
Quantitative continuous EEG for detecting delayed cerebral ischemia in patients with poor-grade subarachnoid hemorrhage
Claassen J, Hirsch LJ, Kreiter KT, Du EY, Connolly ES, Emerson RG, Mayer SA. Quantitative continuous EEG for detecting delayed cerebral ischemia in patients with poor-grade subarachnoid hemorrhage. Clinical Neurophysiology 2004, 115: 2699-2710. PMID: 15546778, DOI: 10.1016/j.clinph.2004.06.017.Peer-Reviewed Original ResearchConceptsPoor-grade subarachnoid hemorrhageDetection of DCISAH patientsSubarachnoid hemorrhageCerebral ischemiaQEEG parametersClinical examHunt-Hess grade 4Poor-grade SAH patientsPost-operative day 2Continuous EEG monitoringInitiation of interventionsAlpha/delta ratioQuantitative EEG parametersNeurological morbidityDCI patientsNeuro-ICUMedian decreasePatientsDay 1EEG monitoringDay 2Day 14Day 4Reasonable specificity