2024
Seizure Assessment and Forecasting With Efficient Rapid-EEG
Kalkach-Aparicio M, Fatima S, Selte A, Sheikh I, Cormier J, Gallagher K, Avagyan G, Cespedes J, Krishnamurthy P, Elazim A, Khan N, Hussein O, Maganti R, Larocque J, Holla S, Desai M, Westover B, Hirsch L, Struck A. Seizure Assessment and Forecasting With Efficient Rapid-EEG. Neurology 2024, 103: e209621. PMID: 38875512, DOI: 10.1212/wnl.0000000000209621.Peer-Reviewed Original ResearchConceptsMonitoring of at-risk patientsRecords of patientsTertiary care centerReceiver operating characteristic curveCritically ill patientsAt-risk patientsClass II evidenceDiagnostic accuracy studiesOperating characteristics curveMedian ageSecondary endpointsPrevent overtreatmentNo significant differenceEEG reviewRisk stratificationNoninferiority marginAntiseizure medicationsClinical correlatesPrimary outcomeII evidenceEEG technologistsSeizure assessmentIll patientsComparative effectiveness studiesLow risk
2022
Hippocampal recording via the RNS system reveals marked ipsilateral activation of epileptiform activity during Wada testing
Quraishi IH, Brown FC, Johnson MH, Hirsch LJ. Hippocampal recording via the RNS system reveals marked ipsilateral activation of epileptiform activity during Wada testing. Epilepsy & Behavior 2022, 134: 108854. PMID: 35905518, DOI: 10.1016/j.yebeh.2022.108854.Peer-Reviewed Original ResearchConceptsResponsive neurostimulation systemWada testingEpileptiform activityElicitation of seizuresTemporal lobe resectionInternal carotid arteryMedial temporal structuresHippocampal vasculatureIpsilateral activationLobe resectionPosterior circulationElectrographic seizuresTemporal lobectomyElectrographic changesIntractable epilepsyClinical correlatesWada testCarotid arteryHippocampal spikesNegative findingsNeurostimulation systemHippocampal EEGHippocampal activityPatientsTransient increase
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 likelihoodPrognostication 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
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 studiesFocal 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
Hirsch LJ, Kull LL. Continuous EEG Monitoring in the Intensive Care Unit. The Neurodiagnostic Journal 2004, 44: 137-158. PMID: 15521467, DOI: 10.1080/1086508x.2004.11079478.Peer-Reviewed Original ResearchConceptsContinuous EEG monitoringIntensive care unitCare unitEEG monitoringPrevention of strokeQuantitative EEG analysisCEEG interpretationCerebral ischemiaIll patientsNonconvulsive seizuresElectrographic seizuresAcute ischemiaClinical correlatesMental statusBrain injuryAlerting stimuliBrain functionEEG patternsEarly detectionEEG technologistsReversible stageIschemiaPatientsSeizuresTechnical difficulties
2003
Tonic–Absence Seizures: An Underrecognized Seizure Type
Shih TT, Hirsch LJ. Tonic–Absence Seizures: An Underrecognized Seizure Type. Epilepsia 2003, 44: 461-465. PMID: 12614405, DOI: 10.1046/j.1528-1157.2003.39602.x.Peer-Reviewed Original ResearchConceptsSymptomatic generalized epilepsySeizure typesTonic seizuresGeneralized epilepsyAbsence seizuresMultiple seizure typesParoxysmal fast activityEpilepsy monitoring unitSlow spikeElectroclinical patternClinical patternStatic encephalopathyClinical correlatesClinical correlationTonic activityInternational LeagueFast activitySeizuresNormal cognitionPatientsEpilepsy diagnosisEpilepsyGPFAMonitoring unitEncephalopathy