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
Pharmacotherapy for Nonconvulsive Seizures and Nonconvulsive Status Epilepticus
Bravo P, Vaddiparti A, Hirsch LJ. Pharmacotherapy for Nonconvulsive Seizures and Nonconvulsive Status Epilepticus. Drugs 2021, 81: 749-770. PMID: 33830480, DOI: 10.1007/s40265-021-01502-4.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusAntiseizure medicationsNonconvulsive seizuresStatus epilepticusIll patientsRefractory nonconvulsive status epilepticusFurther neurological injuryMultiple antiseizure medicationsAdverse neurological outcomesContinuous electroencephalogram monitoringLong-term outcomesHemodynamic labilityRecent neurosurgerySeizure burdenNeurological outcomePharmacological managementBrain infectionGlobal hypoxiaNeurological injuryEarly recognitionMost seizuresUnderlying conditionClinical trialsElectroencephalogram monitoringHepatic function
2020
Assessment 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 screen
2018
The epilepsy bioinformatics study for anti-epileptogenic therapy (EpiBioS4Rx) clinical biomarker: Study design and protocol
Vespa PM, Shrestha V, Abend N, Agoston D, Au A, Bell MJ, Bleck TP, Blanco MB, Claassen J, Diaz-Arrastia R, Duncan D, Ellingson B, Foreman B, Gilmore EJ, Hirsch L, Hunn M, Kamnaksh A, McArthur D, Morokoff A, O'Brien T, O'Phelan K, Robertson CL, Rosenthal E, Staba R, Toga A, Willyerd FA, Zimmermann L, Yam E, Martinez S, Real C, Engel J. The epilepsy bioinformatics study for anti-epileptogenic therapy (EpiBioS4Rx) clinical biomarker: Study design and protocol. Neurobiology Of Disease 2018, 123: 110-114. PMID: 30048805, PMCID: PMC6344322, DOI: 10.1016/j.nbd.2018.07.025.Peer-Reviewed Original ResearchConceptsPost-traumatic epilepsyTraumatic brain injuryIncidence of PTELongitudinal prospective observational studyAnti-epileptogenic therapiesEpilepsy Bioinformatics StudyProspective observational studyFuture interventional studiesModerate-severe TBI patientsHemorrhagic contusionAcute evaluationTBI patientsBlood biomarkersDiscovery of biomarkersInterventional studyBrain injuryElectroencephalographic monitoringObservational studyInternational cohortAnimal modelsClinical biomarkersStudy designBiomarkersMultidisciplinary approachNational InstituteDefinition 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 ResearchConceptsAmerican 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
Standardized computer-based organized reporting of EEG: SCORE – Second version
Beniczky S, Aurlien H, Brøgger JC, Hirsch LJ, Schomer DL, Trinka E, Pressler RM, Wennberg R, Visser GH, Eisermann M, Diehl B, Lesser RP, Kaplan PW, Nguyen The Tich S, Lee JW, Martins-da-Silva A, Stefan H, Neufeld M, Rubboli G, Fabricius M, Gardella E, Terney D, Meritam P, Eichele T, Asano E, Cox F, van Emde Boas W, Mameniskiene R, Marusic P, Zárubová J, Schmitt FC, Rosén I, Fuglsang-Frederiksen A, Ikeda A, MacDonald DB, Terada K, Ugawa Y, Zhou D, Herman ST. Standardized computer-based organized reporting of EEG: SCORE – Second version. Clinical Neurophysiology 2017, 128: 2334-2346. PMID: 28838815, DOI: 10.1016/j.clinph.2017.07.418.Peer-Reviewed Original ResearchConceptsCritical care EEG terminologyUseful clinical toolEEG terminologyNeonatal recordingsClinical careClinical relevanceClinical neurophysiologyClinical practiceDiagnostic significanceClinical toolInternational FederationInternational consensusScoresEEG recordingsStandardized listStandardized terminologyEEGAdditional choiceStandardized termsSeizuresPresurgical language fMRI: Mapping of six critical regions
Benjamin CF, Walshaw PD, Hale K, Gaillard WD, Baxter LC, Berl MM, Polczynska M, Noble S, Alkawadri R, Hirsch LJ, Constable RT, Bookheimer SY. Presurgical language fMRI: Mapping of six critical regions. Human Brain Mapping 2017, 38: 4239-4255. PMID: 28544168, PMCID: PMC5518223, DOI: 10.1002/hbm.23661.Peer-Reviewed Original ResearchConceptsLanguage lateralityWernicke's areaLanguage regionsBasal temporal language areaHum Brain MappTemporal language areaTumor patientsLanguage cortexIndependent cliniciansClinical fMRIExperienced cliniciansCliniciansLanguage mappingLanguage-critical areasSpeech areasAngular gyrusExner's areaLateralityFMRI taskBroca's areaBlind reviewNeurosurgical planningLanguage areasClinical neuropsychologistsFMRI dataBrain‐responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy
Geller EB, Skarpaas TL, Gross RE, Goodman RR, Barkley GL, Bazil CW, Berg MJ, Bergey GK, Cash SS, Cole AJ, Duckrow RB, Edwards JC, Eisenschenk S, Fessler J, Fountain NB, Goldman AM, Gwinn RP, Heck C, Herekar A, Hirsch LJ, Jobst BC, King‐Stephens D, Labar DR, Leiphart JW, Marsh WR, Meador KJ, Mizrahi EM, Murro AM, Nair DR, Noe KH, Park YD, Rutecki PA, Salanova V, Sheth RD, Shields DC, Skidmore C, Smith MC, Spencer DC, Srinivasan S, Tatum W, Van Ness PC, Vossler DG, Wharen RE, Worrell GA, Yoshor D, Zimmerman RS, Cicora K, Sun FT, Morrell MJ. Brain‐responsive neurostimulation in patients with medically intractable mesial temporal lobe epilepsy. Epilepsia 2017, 58: 994-1004. PMID: 28398014, DOI: 10.1111/epi.13740.Peer-Reviewed Original ResearchConceptsMesial temporal lobe epilepsyMesial temporal sclerosisSeizure-free periodTemporal lobe epilepsySeizure reductionAdverse eventsLobe epilepsyIntractable mesial temporal lobe epilepsySerious device-related adverse eventsIntractable partial-onset seizuresMedian percent seizure reductionMesial temporal lobe originBilateral mesial temporal lobe epilepsyDevice-related adverse eventsBrain-responsive neurostimulationImplant site infectionPercent seizure reductionPartial-onset seizuresProspective clinical trialsTemporal lobe originVagus nerve stimulationEffective treatment optionPercent of subjectsPreimplantation baselineTemporal sclerosis
2016
Regional and network relationship in the intracranial EEG second spectrum
Joshi RB, Gaspard N, Goncharova II, Duckrow RB, Duncan D, Gerrard JL, Spencer DD, Hirsch LJ, Zaveri HP. Regional and network relationship in the intracranial EEG second spectrum. Clinical Neurophysiology 2016, 127: 3485-3491. PMID: 27692590, DOI: 10.1016/j.clinph.2016.09.003.Peer-Reviewed Original ResearchProgressive 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
Quantitative EEG Is an Objective, Sensitive, and Reliable Indicator of Transient Anesthetic Effects During Wada Tests
Tu B, Assassi NJ, Bazil CW, Hamberger MJ, Hirsch LJ. Quantitative EEG Is an Objective, Sensitive, and Reliable Indicator of Transient Anesthetic Effects During Wada Tests. Journal Of Clinical Neurophysiology 2015, 32: 152-158. PMID: 25580802, PMCID: PMC4385440, DOI: 10.1097/wnp.0000000000000154.Peer-Reviewed Original Research
2014
The spatial and signal characteristics of physiologic high frequency oscillations
Alkawadri R, Gaspard N, Goncharova II, Spencer DD, Gerrard JL, Zaveri H, Duckrow RB, Blumenfeld H, Hirsch LJ. The spatial and signal characteristics of physiologic high frequency oscillations. Epilepsia 2014, 55: 1986-1995. PMID: 25470216, PMCID: PMC5123742, DOI: 10.1111/epi.12851.Peer-Reviewed Original ResearchConceptsPhysiologic high-frequency oscillationsSeizure onsetEpileptic networkNon-rapid eye movement sleepComprehensive Epilepsy CenterMesial temporal structuresEye movement sleepHighest HFO ratesHigh-frequency oscillationsFirst seizureInvasive evaluationEpilepsy centersIntracranial evaluationMovement sleepPerirolandic regionEpileptiform dischargesParietooccipital regionOccipital lobeEpileptic sitesPatientsNonepileptic regionsPhysiologic eventsFast ripplesHFO ratesLonger duration
2013
Proceedings of the Fourth International Workshop on Advances in Electrocorticography
Ritaccio A, Brunner P, Crone NE, Gunduz A, Hirsch LJ, Kanwisher N, Litt B, Miller K, Moran D, Parvizi J, Ramsey N, Richner TJ, Tandon N, Williams J, Schalk G. Proceedings of the Fourth International Workshop on Advances in Electrocorticography. Epilepsy & Behavior 2013, 29: 259-268. PMID: 24034899, PMCID: PMC3896917, DOI: 10.1016/j.yebeh.2013.08.012.Peer-Reviewed Original ResearchSeizure localization using three-dimensional surface projections of intracranial EEG power
Lee HW, Youngblood MW, Farooque P, Han X, Jhun S, Chen WC, Goncharova I, Vives K, Spencer DD, Zaveri H, Hirsch LJ, Blumenfeld H. Seizure localization using three-dimensional surface projections of intracranial EEG power. NeuroImage 2013, 83: 616-626. PMID: 23850575, PMCID: PMC3815983, DOI: 10.1016/j.neuroimage.2013.07.010.Peer-Reviewed Original ResearchConceptsEpilepsy surgerySeizure localizationGood surgical outcomeEEG powerIntractable epilepsy patientsAgreement rateNormal brain functionOverall agreement ratePoor outcomeSurgical outcomesIntractable epilepsyIcEEG recordingsSeizure onsetSublobar localizationEpilepsy patientsIndependent reviewersClinical informationIcEEG dataPatientsBrain functionSurgeryImproved diagnostic methodIntracranial EEGDiagnostic methodsOutcomes
2011
Imaging findings in encephalocraniocutaneous lipomatosis
Svoronos A, Hirsch LJ, Khandji AG. Imaging findings in encephalocraniocutaneous lipomatosis. Neurology 2011, 77: 694. PMID: 21844526, DOI: 10.1212/wnl.0b013e3182299fa9.Peer-Reviewed Original Research
2010
Is sudden unexpected death in epilepsy due to postictal brain shutdown?
Hirsch LJ. Is sudden unexpected death in epilepsy due to postictal brain shutdown? Annals Of Neurology 2010, 68: 773-775. PMID: 21194146, DOI: 10.1002/ana.22242.Peer-Reviewed Original ResearchIntracranial Multimodal Monitoring for Acute Brain Injury: A Single Institution Review of Current Practices
Stuart RM, Schmidt M, Kurtz P, Waziri A, Helbok R, Mayer SA, Lee K, Badjatia N, Hirsch LJ, Connolly ES, Claassen J. Intracranial Multimodal Monitoring for Acute Brain Injury: A Single Institution Review of Current Practices. Neurocritical Care 2010, 12: 188-198. PMID: 20107926, DOI: 10.1007/s12028-010-9330-9.Peer-Reviewed Original ResearchConceptsAcute brain injuryBrain injurySevere acute brain injuryNeurological intensive care unitInsertion techniqueSecondary brain injuryDay of admissionMethodsSixty-one patientsRate of hematomaSingle-institution reviewIntensive care unitBrain tissue oxygenCerebral blood flowFocal brain injuryMultimodality brain monitoringPatient-specific selectionInvasive monitoring devicesHospital lengthFrequent complicationNICU lengthPatient demographicsCare unitMultimodality monitoringConsecutive seriesInstitution review
2009
Continuous Electroencephalogram Monitoring in the Intensive Care Unit
Friedman D, Claassen J, Hirsch LJ. Continuous Electroencephalogram Monitoring in the Intensive Care Unit. Anesthesia & Analgesia 2009, 109: 506-523. PMID: 19608827, DOI: 10.1213/ane.0b013e3181a9d8b5.Peer-Reviewed Original ResearchConceptsContinuous EEG monitoringNonconvulsive seizuresIll patientsIntracranial pressureBrain functionContinuous electroencephalogram monitoringConvulsive status epilepticusIntensive care unitMajority of seizuresMultimodality brain monitoringPharmacological comaNeurologic outcomeNeurologic statusNeuronal injuryBrain ischemiaStatus epilepticusCare unitSecondary injurySubarachnoid hemorrhageCEEG monitoringClinical examinationElectroencephalogram monitoringSystemic abnormalitiesIntracranial EEG recordingsHigh riskClinical use of ictal SPECT in secondarily generalized tonic–clonic seizures
Varghese GI, Purcaro MJ, Motelow JE, Enev M, McNally KA, Levin AR, Hirsch LJ, Tikofsky R, Paige AL, Zubal IG, Spencer SS, Blumenfeld H. Clinical use of ictal SPECT in secondarily generalized tonic–clonic seizures. Brain 2009, 132: 2102-2113. PMID: 19339251, PMCID: PMC2714057, DOI: 10.1093/brain/awp027.Peer-Reviewed Original ResearchConceptsCerebral blood flow increasesBlood flow increasesGeneralized tonic-clonic seizuresIctal SPECTTonic-clonic seizuresPartial seizuresPost-ictal periodSeizure onsetGeneralized seizuresSecondary generalizationCerebral blood flow decreasesRegional cerebral blood flow increasesPropagation of seizuresBlood flow decreaseCerebral blood flowEpilepsy surgery evaluationUseful clinical toolSingle photon emissionFlow increasesSeizure localizationSurgery evaluationBlood flowSeizuresClinical toolClinical use
2006
In Nonconvulsive Status Epilepticus (NCSE), Treat to Burst‐Suppression: Pro and Con
Jordan KG, Hirsch LJ. In Nonconvulsive Status Epilepticus (NCSE), Treat to Burst‐Suppression: Pro and Con. Epilepsia 2006, 47: 41-45. PMID: 17044825, DOI: 10.1111/j.1528-1167.2006.00659.x.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusNonconvulsive seizuresRefractory nonconvulsive status epilepticusPermanent neuronal injuryAcute brain injuryIntensive care interventionsHigh mortality rateNeuronal injuryStatus epilepticusIatrogenic complicationsBrain damageBrain injuryCare interventionsDr. HirschBurst suppressionMortality rateExpert managementSeizuresInjuryMost casesEpilepticusMedicationsComplicationsDr. Jordan