2024
Early vigabatrin to augment GABAergic pathways in post-anoxic status epilepticus
Maciel C, Ahmad B, Jose Bruzzone Giraldez M, Eisenschenk S, Ramsay E, Maranchick N, Peloquin C, Hirsch L, Busl K. Early vigabatrin to augment GABAergic pathways in post-anoxic status epilepticus. Epilepsy & Behavior 2024, 160: 110082. PMID: 39393141, DOI: 10.1016/j.yebeh.2024.110082.Peer-Reviewed Original ResearchStatus epilepticusGamma-aminobutyric acidGABAergic pathwayHypoxic-ischemic brain injuryPost-cardiac arrest periodHypoxic-ischemic insultOutcomes of patientsEffective adjunctive therapyInhibition of gamma-aminobutyric acidLondon-Innsbruck ColloquiumAdjunctive therapyAcute seizuresEffective therapyPoor outcomeEpilepticusExclusion criteriaEarly inhibitionSynergistic augmentationGamma-aminobutyric acid catabolismArrest periodTherapeutic nihilismSeizuresClinal trialsAllosteric modulatorsVigabatrin
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
2019
Continuous EEG Findings in Autoimmune Encephalitis.
Moise AM, Karakis I, Herlopian A, Dhakar M, Hirsch LJ, Cotsonis G, LaRoche S, Cabrera Kang CM, Westover B, Rodriguez A. Continuous EEG Findings in Autoimmune Encephalitis. Journal Of Clinical Neurophysiology 2019, 38: 124-129. PMID: 31800465, PMCID: PMC7263965, DOI: 10.1097/wnp.0000000000000654.Peer-Reviewed Original ResearchConceptsNew-onset refractory status epilepticusRefractory status epilepticusRhythmic delta activityGeneralized rhythmic delta activityAutoimmune encephalitisStatus epilepticusDelta activityPoor outcomeAE subtypeFast activityAntibody-negative autoimmune encephalitisN-methyl-D-aspartate receptorsDefinite limbic encephalitisExtreme delta brushMulticenter retrospective reviewNew-onset seizuresContinuous EEG monitoringGlutamic acid decarboxylaseVoltage-gated potassium channelsLimbic encephalitisRetrospective reviewAE patientsElectrographic seizuresDelta brushEEG findings
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 implicationsOutcomesBilateral independent periodic discharges are associated with electrographic seizures and poor outcome: a case-control study (P3.276)
Osman G, Rahangdale R, Britton J, Gilmore E, Haider H, Hantus S, Herlopian A, Hocker S, Lee J, Legros B, Punia V, Rampal N, Szaflarski J, Wallace A, Westover M, Hirsch L, Gaspard N. Bilateral independent periodic discharges are associated with electrographic seizures and poor outcome: a case-control study (P3.276). Neurology 2018, 90 DOI: 10.1212/wnl.90.15_supplement.p3.276.Peer-Reviewed Original Research
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
New-onset refractory status epilepticus
Gaspard N, Foreman BP, Alvarez V, Cabrera Kang C, Probasco JC, Jongeling AC, Meyers E, Espinera A, Haas KF, Schmitt SE, Gerard EE, Gofton T, Kaplan PW, Lee JW, Legros B, Szaflarski JP, Westover BM, LaRoche SM, Hirsch LJ, Fertig E, Herman S, Huh L, Lee J, Loddenkemper T, Chapman K, Abend N, Carpenter J, Hantus S, Claassen J, Husain A, Gaspard N, LaRoche S, Ritzl E, Gofton T, Wusthoff C, Goldstein J, Westover B, Hocker S, Halford J, Jones J, Gerard E, Schmitt S, Williams K, Hahn C, Szaflarski J, Kramer A, Rudzinski L, Hopp J, Mani R, Kalamangalam G, Gupta P, Quigg M, Haas K, Ostendorf A, Zutshi D, Hirsch L. New-onset refractory status epilepticus. Neurology 2015, 85: 1604-1613. PMID: 26296517, PMCID: PMC4642147, DOI: 10.1212/wnl.0000000000001940.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overAnestheticsAnticonvulsantsAnti-N-Methyl-D-Aspartate Receptor EncephalitisAutoantibodiesCohort StudiesEncephalitisEncephalitis, Herpes SimplexFemaleHashimoto DiseaseHumansLength of StayMaleMiddle AgedParaneoplastic Syndromes, Nervous SystemPotassium Channels, Voltage-GatedPrognosisRetrospective StudiesStatus EpilepticusTime FactorsTreatment OutcomeYoung AdultConceptsNew-onset refractory status epilepticusRefractory status epilepticusStatus epilepticusPoor outcomeTherapy warrants further investigationInflammatory CSF changesHours of admissionPrimary outcome measurePoor functional outcomePredictors of outcomeAcademic medical centerWarrants further investigationUse of anestheticsRole of anestheticsAutoimmune encephalitisAntiseizure medicationsCryptogenic casesParaneoplastic encephalitisMedical complicationsRetrospective reviewAvailable followClinical featuresImmune therapyFunctional outcomeFunctional statusPrognostication 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
Continuous electroencephalography in a surgical intensive care unit
Kurtz P, Gaspard N, Wahl AS, Bauer RM, Hirsch LJ, Wunsch H, Claassen J. Continuous electroencephalography in a surgical intensive care unit. Intensive Care Medicine 2013, 40: 228-234. PMID: 24240843, DOI: 10.1007/s00134-013-3149-8.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusPeriodic epileptiform dischargesNonconvulsive seizuresPoor outcomeClinical seizuresSICU patientsRetrospective studyCEEG monitoringMental statusSurgical intensive care unit patientsIntensive care unit patientsSurgical intensive care unitCare unit patientsContinuous electroencephalography monitoringMajority of patientsIntensive care unitMultivariable logistic regressionLiver transplantationHospital dischargeUnit patientsAbdominal surgeryPrimary outcomeStatus epilepticusCare unitMean ageSeizure 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
2010
Seizures and CNS Hemorrhage
Gilmore E, Choi HA, Hirsch LJ, Claassen J. Seizures and CNS Hemorrhage. The Neurologist 2010, 16: 165-175. PMID: 20445426, DOI: 10.1097/nrl.0b013e3181c7cd0b.Peer-Reviewed Original ResearchConceptsAneurysmal subarachnoid hemorrhageCentral nervous system hemorrhageShort-term prophylaxisNonconvulsive seizuresIntracerebral hemorrhageSpontaneous intracerebral hemorrhageSeizure prophylaxisASAH patientsAdditional injuriesAcute brain injuryPoor clinical gradeEvidence-based guidelinesCommon neurologic conditionsDeleterious effectsAntiepileptic medicationsControlled TrialsConvulsive seizuresCNS hemorrhagePoor outcomeSubarachnoid hemorrhageNeurologic conditionsSurrogate markerBrain injuryClinical gradeRecent injury
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 studies
2006
Prognostic significance of continuous EEG monitoring in patients with poor-grade subarachnoid hemorrhage
Claassen J, Hirsch LJ, Frontera JA, Fernandez A, Schmidt M, Kapinos G, Wittman J, Connolly ES, Emerson RG, Mayer SA. Prognostic significance of continuous EEG monitoring in patients with poor-grade subarachnoid hemorrhage. Neurocritical Care 2006, 4: 103-112. PMID: 16627897, DOI: 10.1385/ncc:4:2:103.Peer-Reviewed Original ResearchConceptsModified Rankin ScalePeriodic lateralized epileptiform dischargesSubarachnoid hemorrhageHess gradePoor outcomeEEG findingsCEEG monitoringEpileptiform dischargesPoor-grade subarachnoid hemorrhageMultivariate logistic regression analysisAdmission CT scanPeriodic epileptiform dischargesLogistic regression analysisRankin ScaleIll patientsIntraventricular hemorrhageMRS 4Functional outcomeSleep architectureEEG reactivityCT scanPatientsOutcomesHemorrhageRegression analysis