2019
Quantitative Electroencephalogram Trends Predict Recovery in Hypoxic-Ischemic Encephalopathy.
Ghassemi MM, Amorim E, Alhanai T, Lee JW, Herman ST, Sivaraju A, Gaspard N, Hirsch LJ, Scirica BM, Biswal S, Moura Junior V, Cash SS, Brown EN, Mark RG, Westover MB. Quantitative Electroencephalogram Trends Predict Recovery in Hypoxic-Ischemic Encephalopathy. Critical Care Medicine 2019, 47: 1416-1423. PMID: 31241498, PMCID: PMC6746597, DOI: 10.1097/ccm.0000000000003840.Peer-Reviewed Original ResearchConceptsHypoxic-ischemic encephalopathyNeurologic outcomeElectroencephalogram featuresAcute hypoxic-ischemic encephalopathyAcademic medical centerBetter prognostic predictionReceiver operator curveNeurologic recoveryComatose patientsPrognostic implicationsCardiac arrestMedical CenterPrognostication performancePrognostic predictionOperator curveLogistic regressionSequential logistic regressionSpecificity thresholdEncephalopathyStatistical associationOutcomes
2018
Definition 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
2015
Quantification of EEG reactivity in comatose patients
Hermans MC, Westover MB, van Putten MJ, Hirsch LJ, Gaspard N. Quantification of EEG reactivity in comatose patients. Clinical Neurophysiology 2015, 127: 571-580. PMID: 26183757, PMCID: PMC4885124, DOI: 10.1016/j.clinph.2015.06.024.Peer-Reviewed Original ResearchConceptsComatose patientsPrognostication of post-cardiac arrest coma: early clinical and electroencephalographic predictors of outcome
Sivaraju A, Gilmore EJ, Wira CR, Stevens A, Rampal N, Moeller JJ, Greer DM, Hirsch LJ, Gaspard N. Prognostication of post-cardiac arrest coma: early clinical and electroencephalographic predictors of outcome. Intensive Care Medicine 2015, 41: 1264-1272. PMID: 25940963, DOI: 10.1007/s00134-015-3834-x.Peer-Reviewed Original ResearchConceptsBetter outcomesPoor outcomeEpileptiform dischargesPost-cardiac arrest comatose patientsCritical care EEG terminologyPost-cardiac arrest comaMethodsProspective cohort studyContinuous EEG monitoringLow-voltage EEGPositive predictive valueAbsence of reactivityEEG terminologyCohort studySpontaneous circulationBrainstem reflexesClinical outcomesComatose patientsFalse positive ratePoor prognosisPrognostic significanceSuppression burstsClinical variablesClinical correlatesElectroencephalographic patternsElectroencephalographic predictors
2013
Pitfalls in ictal EEG interpretation
Gaspard N, Hirsch LJ. Pitfalls in ictal EEG interpretation. Neurology 2013, 80: s26-s42. PMID: 23267042, DOI: 10.1212/wnl.0b013e31827974f8.Peer-Reviewed Original Research
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
2005
Continuous EEG Monitoring in Patients With Subarachnoid Hemorrhage
Claassen J, Mayer SA, Hirsch LJ. Continuous EEG Monitoring in Patients With Subarachnoid Hemorrhage. Journal Of Clinical Neurophysiology 2005, 22: 92-98. PMID: 15805808, DOI: 10.1097/01.wnp.0000145006.02048.3a.Peer-Reviewed Original ResearchConceptsContinuous EEG monitoringSubarachnoid hemorrhageEEG monitoringPoor-grade subarachnoid hemorrhageAdditional diagnostic interventionsQuantitative EEG analysisCEEG findingsCerebral ischemiaNeurological examComatose patientsSAH patientsCEEG monitoringClinical correlatesDiagnostic interventionsClinical examPatientsEEG changesIschemiaSeizuresReversible stageVasospasmHemorrhageRiskLimited utilityEEG analysis
2004
Continuous EEG Monitoring in the Intensive Care Unit: An Overview
Hirsch LJ. Continuous EEG Monitoring in the Intensive Care Unit: An Overview. Journal Of Clinical Neurophysiology 2004, 21: 332-340. PMID: 15592007, DOI: 10.1097/01.wnp.0000147129.80917.0e.Peer-Reviewed Original ResearchConceptsPeriodic epileptiform dischargesComatose patientsEpileptiform dischargesEEG patternsIntensive care unitLevel of sedationContinuous EEG monitoringMajority of seizuresHospital infarctionNoncomatose patientsRecent neurosurgeryClinical seizuresCNS infectionICU patientsIll patientsNonconvulsive seizuresCare unitWorse outcomesAutonomic changesParoxysmal spellsBrain tumorsPatientsEEG monitoringEEG trendsSeizures
2002
Nonconvulsive Status Epilepticus after Subarachnoid Hemorrhage
Dennis LJ, Claassen J, Hirsch LJ, Emerson RG, Connolly ES, Mayer SA. Nonconvulsive Status Epilepticus after Subarachnoid Hemorrhage. Neurosurgery 2002, 51: 1136. PMID: 12383358, DOI: 10.1097/00006123-200211000-00006.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusAneurysmal subarachnoid hemorrhageSubarachnoid hemorrhageCEEG monitoringUnexplained comaNeurological deteriorationStatus epilepticusRefractory nonconvulsive status epilepticusNeurological intensive care unitProphylactic anticonvulsant therapyHours of hospitalizationContinuous electroencephalographic monitoringIntensive care unitAnticonvulsant administrationHospital seizuresAnticonvulsant therapyCerebral edemaClinical improvementHess gradeCare unitClinical featuresComatose patientsElectrographic seizuresVentricular drainageMidazolam therapy