2022
Electroencephalogram in the intensive care unit: a focused look at acute brain injury
Alkhachroum A, Appavu B, Egawa S, Foreman B, Gaspard N, Gilmore EJ, Hirsch LJ, Kurtz P, Lambrecq V, Kromm J, Vespa P, Zafar SF, Rohaut B, Claassen J. Electroencephalogram in the intensive care unit: a focused look at acute brain injury. Intensive Care Medicine 2022, 48: 1443-1462. PMID: 35997792, PMCID: PMC10008537, DOI: 10.1007/s00134-022-06854-3.Peer-Reviewed Original ResearchConceptsAcute brain injuryNonconvulsive status epilepticusBrain injuryStatus epilepticusEEG monitoringIntensive care unit settingRefractory status epilepticusSecondary brain injuryIntensive care unitPossible clinical relevanceAssessment of consciousnessResource-limited settingsICU EEG monitoringFrequent seizuresAcute illnessCommon indicationCare unitWorse outcomesUnit settingClinical relevancePathophysiological eventsSeizure criteriaIschemia monitoringInjuryApplication of electroencephalography
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 analysisEEGMorbidity
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 implicationsOutcomes
2017
Cyclic 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 likelihoodThe enigma of the latent period in the development of symptomatic acquired epilepsy — Traditional view versus new concepts
Löscher W, Hirsch LJ, Schmidt D. The enigma of the latent period in the development of symptomatic acquired epilepsy — Traditional view versus new concepts. Epilepsy & Behavior 2015, 52: 78-92. PMID: 26409135, DOI: 10.1016/j.yebeh.2015.08.037.Peer-Reviewed Original ResearchConceptsBrain injuryLatent periodBrain insultsAnimal modelsMajor unmet clinical needPre-epileptic stateProcess of epileptogenesisUnderstanding of epileptogenesisTraumatic brain injuryUnmet clinical needAntiepileptogenic agentsAntiepileptogenic treatmentsSymptomatic epilepsyHuman epilepsyTrial designFunctional alterationsEpileptogenesisEpilepsySubclinical epilepsyClinical needInjuryPatientsRecent dataInsultPeriod
2012
Epilepsy Emergencies: Diagnosis and Management
Foreman B, Hirsch LJ. Epilepsy Emergencies: Diagnosis and Management. Neurologic Clinics 2012, 30: 11-41. PMID: 22284053, DOI: 10.1016/j.ncl.2011.09.005.Peer-Reviewed Original ResearchConceptsStatus epilepticusLimited evidence-based guidanceIrreversible brain injuryNonconvulsive status epilepticusEvidence-based guidanceEpilepsy emergenciesNonconvulsive seizuresHigh morbidityBrain injuryEarly treatmentTreatment responseProlonged casesRefractory conditionEpilepticusPatientsPrognosisSeizuresTreatmentDiagnosisMorbidityComatoseInjuryMortality
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
2005
Continuous electroencephalogram monitoring in critically ill patients
Jette N, Hirsch LJ. Continuous electroencephalogram monitoring in critically ill patients. Current Neurology And Neuroscience Reports 2005, 5: 312-321. PMID: 15987616, DOI: 10.1007/s11910-005-0077-1.Peer-Reviewed Original ResearchConceptsContinuous EEG monitoringIll patientsPermanent neuronal injuryContinuous electroencephalogram monitoringStandard of careRhythmic EEG patternsNeuronal injuryCerebral ischemiaNonconvulsive seizuresNeurologic impairmentClinical managementContinuous brain monitoringElectroencephalogram monitoringEEG monitoringPatientsEEG patternsBrain monitoringFurther studiesSeizuresIndicationsRemarkable advancesIschemiaInjuryPrognosticationImpairmentContinuous electroencephalogram monitoring in the critically III
Wittman JJ, Hirsch LJ. Continuous electroencephalogram monitoring in the critically III. Neurocritical Care 2005, 2: 330-341. PMID: 16159085, DOI: 10.1385/ncc:2:3:330.Peer-Reviewed Original ResearchWhich 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 recommendationsDischargePatientsEtiologyInjuryDiagnosis