2024
Evaluating the Impact of Point-of-Care Electroencephalography on Length of Stay in the Intensive Care Unit: Subanalysis of the SAFER-EEG Trial
Desai M, Kalkach-Aparicio M, Sheikh I, Cormier J, Gallagher K, Hussein O, Cespedes J, Hirsch L, Westover B, Struck A. Evaluating the Impact of Point-of-Care Electroencephalography on Length of Stay in the Intensive Care Unit: Subanalysis of the SAFER-EEG Trial. Neurocritical Care 2024, 1-10. PMID: 38981999, DOI: 10.1007/s12028-024-02039-6.Peer-Reviewed Original ResearchIntensive care unitIntensive care unit LOSNonconvulsive seizuresClinical outcomesFunctional outcomesCare unitDetection of nonconvulsive seizuresInterquartile rangeAssociated with neuronal injuryDiagnose nonconvulsive seizuresIntensive care unit patientsUnfavorable functional outcomeMann-Whitney U testProlonged nonconvulsive seizuresPropensity score matchingDeleterious clinical outcomesClinical characteristicsAdult patientsRandomized studyConventional EEGICU LOSNeuronal injuryFunctional/clinical outcomesAcademic centersClinical covariates
2020
Deep Versus Lobar Intraparenchymal Hemorrhage: Seizures, Hyperexcitable Patterns, and Clinical Outcomes.
Sheikh ZB, Stretz C, Maciel CB, Dhakar MB, Orgass H, Petroff OA, Hirsch LJ, Gilmore EJ. Deep Versus Lobar Intraparenchymal Hemorrhage: Seizures, Hyperexcitable Patterns, and Clinical Outcomes. Critical Care Medicine 2020, 48: e505-e513. PMID: 32301843, DOI: 10.1097/ccm.0000000000004317.Peer-Reviewed Original ResearchConceptsDeep intraparenchymal hemorrhageElectrographic seizuresIntraparenchymal hemorrhageRhythmic delta activityTemporal lobe involvementPoor outcomeLobar groupThalamic involvementClinical outcomesLobe involvementDelta activityTertiary academic medical centerNontraumatic intraparenchymal hemorrhagesConsecutive adult patientsRetrospective cohort studyFisher's exact testMann-Whitney U testAcademic medical centerSpike-wave complexesIntraparenchymal hemorrhage volumeAdult patientsCohort studyMultivariable analysisHematoma volumeInsular involvement
2018
Prevalence and predictors of seizure clusters: A prospective observational study of adult patients with epilepsy
Detyniecki K, O'Bryan J, Choezom T, Rak G, Ma C, Zhang S, Bonito J, Hirsch LJ. Prevalence and predictors of seizure clusters: A prospective observational study of adult patients with epilepsy. Epilepsy & Behavior 2018, 88: 349-356. PMID: 30344026, DOI: 10.1016/j.yebeh.2018.09.035.Peer-Reviewed Original ResearchConceptsRescue medication useProspective observational studyEmergency department visitsHigh seizure frequencySeizure clustersAdult patientsRescue medicationClinical characteristicsSeizure frequencyActive epilepsyDepartment visitsMedication useObservational studyExact testSeizure-related outcomesFisher's exact testLogistic regression modelsSeizure clusteringAdverse outcomesEpilepsy severitySeizure diariesIndividual patientsPatientsEpilepsyFinal analysisCross-sensitivity of psychiatric and behavioral side effects with antiepileptic drug use
Chen B, Choi H, Hirsch LJ, Legge A, Buchsbaum R, Detyniecki K. Cross-sensitivity of psychiatric and behavioral side effects with antiepileptic drug use. Seizure 2018, 62: 38-42. PMID: 30273800, DOI: 10.1016/j.seizure.2018.09.014.Peer-Reviewed Original ResearchConceptsBehavioral side effectsMore antiepileptic drugsAntiepileptic drugsSide effectsAdult patientsSpecific antiepileptic drugsAntiepileptic drug useCertain antiepileptic drugsHistory of depressionAED usePatientsDrug useSignificant predictorsSignificant increasePsychosisDepressionZNSConfoundersEpilepsyDose
2017
Psychiatric and behavioral side effects of antiepileptic drugs in adults with epilepsy
Chen B, Choi H, Hirsch LJ, Katz A, Legge A, Buchsbaum R, Detyniecki K. Psychiatric and behavioral side effects of antiepileptic drugs in adults with epilepsy. Epilepsy & Behavior 2017, 76: 24-31. PMID: 28931473, DOI: 10.1016/j.yebeh.2017.08.039.Peer-Reviewed Original ResearchConceptsBehavioral side effectsSide effectsPractice-based sampleAntiepileptic drug useHigh rateAED regimenAdult patientsNewer AEDsCessation ratesAntiepileptic drugsIntractable epilepsyMedical historyAbsence seizuresMedical recordsPhysician reportsAED usePatientsLevetiracetamDepressive moodDrug useGabapentinLamotriginePatient recordsSuicidal thoughtsPhenytoinBrief 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 recordingsPrevalence and risk factors of seizure clusters in adult patients with epilepsy
Chen B, Choi H, Hirsch LJ, Katz A, Legge A, Wong RA, Jiang A, Kato K, Buchsbaum R, Detyniecki K. Prevalence and risk factors of seizure clusters in adult patients with epilepsy. Epilepsy Research 2017, 133: 98-102. PMID: 28475999, DOI: 10.1016/j.eplepsyres.2017.04.016.Peer-Reviewed Original ResearchConceptsSymptomatic generalized epilepsyIdiopathic generalized epilepsySeizure clustersEpilepsy typeStatus epilepticusCortical dysplasiaGeneralized epilepsyFocal epilepsySeizure onsetCNS infectionSeizure freedomMore AEDsRisk factorsCentral nervous system infectionCongenital brain injuryEpilepsy risk factorsNervous system infectionPotential clinical factorsComplex partial seizuresEarly seizure onsetEpilepsy detailsRescue medicationAdult patientsPatient demographicsSystem infection
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 trajectories
2012
Extreme delta brush
Schmitt SE, Pargeon K, Frechette ES, Hirsch LJ, Dalmau J, Friedman D. Extreme delta brush. Neurology 2012, 79: 1094-1100. PMID: 22933737, PMCID: PMC3525298, DOI: 10.1212/wnl.0b013e3182698cd8.Peer-Reviewed Original ResearchConceptsExtreme delta brushAnti-NMDAR encephalitisDelta brushCEEG monitoringAdult patientsAnti-NMDA receptor encephalitisExtreme delta brush patternModified Rankin Scale scoreRankin Scale scoreLarge academic medical centerAcademic medical centerContinuous EEG patternReceptor encephalitisPremature infantsProlonged hospitalizationCommon symptomsMedian lengthEEG findingsElectrographic patternsProlonged illnessMovement disordersMedical CenterPatientsScale scoreEncephalitis
2009
How Long Does It Take to Make an Accurate Diagnosis in an Epilepsy Monitoring Unit?
Friedman DE, Hirsch LJ. How Long Does It Take to Make an Accurate Diagnosis in an Epilepsy Monitoring Unit? Journal Of Clinical Neurophysiology 2009, 26: 213-217. PMID: 19584746, DOI: 10.1097/wnp.0b013e3181b2f2da.Peer-Reviewed Original ResearchConceptsInterictal epileptiform dischargesEpilepsy monitoring unitDefinite epilepsyNonepileptic eventsEpileptic seizuresEpileptiform dischargesAccurate diagnosisMore daysPercent of patientsConsecutive adult patientsExistence of patientsAdult patientsInterictal electroencephalographyMedian timeRetrospective reviewPresurgical evaluationSeizures in Patients Undergoing Resection of Low‐Grade Gliomas
Hirsch LJ. Seizures in Patients Undergoing Resection of Low‐Grade Gliomas. Epilepsy Currents 2009, 9: 98-100. PMID: 19693324, PMCID: PMC2728484, DOI: 10.1111/j.1535-7511.2009.01305.x.Peer-Reviewed Original ResearchLow-grade gliomasPostoperative seizure controlGross total resectionSeizure controlSeizure characteristicsLong seizure historyPatients Undergoing ResectionRetrospective chart reviewCohort of patientsMajority of patientsPoor seizure controlTreatment-related variablesSimple partial seizuresUndergoing resectionInitial surgeryPharmacoresistant seizuresSeizure improvementSeizure recurrenceAdult patientsChart reviewRare seizuresSubtotal resectionSurgical resectionFavorable prognosisPartial seizures
2007
ApoE, MemorE, and EpilepsE
Hirsch LJ. ApoE, MemorE, and EpilepsE. Epilepsy Currents 2007, 7: 149-150. PMID: 18049720, PMCID: PMC2096726, DOI: 10.1111/j.1535-7511.2007.00208.x.Peer-Reviewed Original ResearchMemory performanceIntractable temporal lobe epilepsyTemporal lobe epilepsyPoorer memory performanceApoE-4 statusTemporal lobectomyDuration of epilepsyLobe epilepsyNonverbal measuresTest performanceReduced memoryAPOE-4 alleleSignificant interactionAdult patientsAPOE 4EpilepsyPatientsLonger durationMemoryLobectomyRelationshipApoEGeneralized 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 regression
2002
Treatment of Refractory Status Epilepticus with Pentobarbital, Propofol, or Midazolam: A Systematic Review
Claassen J, Hirsch LJ, Emerson RG, Mayer SA. Treatment of Refractory Status Epilepticus with Pentobarbital, Propofol, or Midazolam: A Systematic Review. Epilepsia 2002, 43: 146-153. PMID: 11903460, DOI: 10.1046/j.1528-1157.2002.28501.x.Peer-Reviewed Original ResearchConceptsRefractory status epilepticusEEG background suppressionTreatment of RSEContinuous EEG monitoringChoice of agentTitration goalsEEG monitoringSystematic reviewBreakthrough seizuresStatus epilepticusTreatment failureShort-term treatment failureFrequency of hypotensionImmediate treatment failureTitration of treatmentPercent of patientsUse of midazolamMain outcome measuresEfficacy of midazolamRSE patientsSE refractoryStandard AEDsAdult patientsAntiepileptic drugsPTB treatment