2024
Systematic 1 Hz direct electrical stimulation for seizure induction: A reliable method for localizing seizure onset zone and predicting seizure freedom
Sivaraju A, Quraishi I, Collins E, McGrath H, Ramos A, Turk-Browne N, Zaveri H, Damisah E, Spencer D, Hirsch L. Systematic 1 Hz direct electrical stimulation for seizure induction: A reliable method for localizing seizure onset zone and predicting seizure freedom. Brain Stimulation 2024, 17: 339-345. PMID: 38490472, DOI: 10.1016/j.brs.2024.03.011.Peer-Reviewed Original ResearchSeizure inductionSeizure onset zoneSurgical outcomesHabitual seizuresOnset zonePredicting seizure freedomExcellent surgical outcomesProspective cohort studyMann-Whitney testConsecutive patientsFisher's exactSeizure freedomRefractory epilepsyCohort studyPost-surgeryInsular regionsMann-WhitneyPatientsIntracranial EEGSeizuresLocalizing seizure onset zonesStimulationElectrical stimulationMedial temporal regionsTemporal regions
2022
Association of Serum Pyridoxal Phosphate Levels with Established Status Epilepticus
Rubinos C, Bruzzone MJ, Blodgett C, Tsai C, Patel P, Hianik R, Jadav R, Boudesseul J, Liu C, Zhu H, Wilson SE, Olm-Shipman C, Meeker R, Hirsch LJ. Association of Serum Pyridoxal Phosphate Levels with Established Status Epilepticus. Neurocritical Care 2022, 38: 41-51. PMID: 36071331, DOI: 10.1007/s12028-022-01579-z.Peer-Reviewed Original ResearchConceptsStatus epilepticusPyridoxal phosphate levelsPLP levelsPyridoxine deficiencyHigh prevalenceControl groupMethodsThis retrospective cohort studyIntensive care unit patientsYale-New Haven HospitalCritical illness severitySerum PLP levelsRetrospective cohort studyCare unit patientsNon-ICU inpatientsPhosphate levelsHistory of epilepsyRole of pyridoxineNorth Carolina HospitalsNew Haven HospitalUnit patientsCohort studyMedian ageIllness severityPyridoxine supplementationProspective study
2021
Electroencephalographic Abnormalities are Common in COVID‐19 and are Associated with Outcomes
Lin L, Al‐Faraj A, Ayub N, Bravo P, Das S, Ferlini L, Karakis I, Lee JW, Mukerji SS, Newey CR, Pathmanathan J, Abdennadher M, Casassa C, Gaspard N, Goldenholz DM, Gilmore EJ, Jing J, Kim JA, Kimchi EY, Ladha HS, Tobochnik S, Zafar S, Hirsch LJ, Westover MB, Shafi MM. Electroencephalographic Abnormalities are Common in COVID‐19 and are Associated with Outcomes. Annals Of Neurology 2021, 89: 872-883. PMID: 33704826, PMCID: PMC8104061, DOI: 10.1002/ana.26060.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusElectrographic seizuresClinical outcomesEpileptiform abnormalitiesRisk factorsPresence of NCSEMultivariate Cox proportional hazards analysisMulticenter retrospective cohort studyCox proportional hazards analysisCOVID-19Retrospective cohort studyClinical risk factorsContinuous electroencephalogram monitoringAdverse clinical outcomesProportional hazards analysisCoronavirus disease 2019Ann NeurolHospital mortalityHospital lengthClinical seizuresCohort studyIndependent predictorsStatus epilepticusEEG findingsElectroencephalographic abnormalitiesVideo quality using outpatient smartphone videos in epilepsy: Results from the OSmartViE study
Tatum WO, Hirsch LJ, Gelfand MA, Acton EK, LaFrance WC, Duckrow RB, Chen D, Blum AS, Hixson J, Drazkowski J, Benbadis S, Cascino GD, Collaborators T. Video quality using outpatient smartphone videos in epilepsy: Results from the OSmartViE study. European Journal Of Neurology 2021, 28: 1453-1462. PMID: 33465822, DOI: 10.1111/ene.14744.Peer-Reviewed Original ResearchConceptsPsychogenic nonepileptic attacksNeurologic eventsEpileptic seizuresInpatient video-electroencephalography (EEG) monitoringPhysiologic nonepileptic eventsMulticenter cohort studyMajority of patientsVideo-electroencephalography monitoringVideo-EEG monitoringSimilar diagnostic accuracyHome video recordingEpilepsy outpatientsNeurological disease statesCohort studyNeurological eventsNonepileptic eventsNonepileptic attacksUnknown diagnosisAdequate durationClinical informationPatientsSenior neurology residentsAccurate diagnosisDiagnostic accuracyNeurology residents
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
Adherence with psychotherapy and treatment outcomes for psychogenic nonepileptic seizures.
Tolchin B, Dworetzky BA, Martino S, Blumenfeld H, Hirsch LJ, Baslet G. Adherence with psychotherapy and treatment outcomes for psychogenic nonepileptic seizures. Neurology 2019, 92: e675-e679. PMID: 30610097, PMCID: PMC6382361, DOI: 10.1212/wnl.0000000000006848.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAdult Survivors of Child AbuseAgedAged, 80 and overCohort StudiesConversion DisorderEmergency Service, HospitalEthnicityFemaleFollow-Up StudiesHumansMaleMiddle AgedMinority GroupsOdds RatioProspective StudiesPsychotherapyQuality of LifeSeizuresTreatment Adherence and ComplianceTreatment OutcomeYoung AdultConceptsPsychogenic nonepileptic seizuresQuality of lifePNES frequencyNonepileptic seizuresProspective cohort studyEmergency department utilizationTime of referralBaseline characteristicsCohort studyED visitsSeizure frequencyED utilizationPotential confoundersWomen's HospitalTreatment outcomesMedium effect sizeLocal therapistsMultivariate modelAdherenceChildhood abuseSeizuresHospitalSignificant reductionOutcomesEffect size
2018
Association between death and loss of stage N2 sleep features among critically Ill patients with delirium
Knauert MP, Gilmore EJ, Murphy TE, Yaggi HK, Van Ness PH, Han L, Hirsch LJ, Pisani MA. Association between death and loss of stage N2 sleep features among critically Ill patients with delirium. Journal Of Critical Care 2018, 48: 124-129. PMID: 30179762, PMCID: PMC6226351, DOI: 10.1016/j.jcrc.2018.08.028.Peer-Reviewed Original ResearchConceptsICU patientsIll patientsOdds ratioHigher oddsSleep spindlesIntensive care unit outcomesGrade of encephalopathySignificant sleep disruptionWorse ICU outcomeMedical ICU patientsAcute brain injuryObservational cohort studySedative-hypnotic useImportant prognostic valueLength of stayStage N2 sleepK-complexesCohort studyCritical illnessHospital dischargeRankin ScaleICU outcomesPrognostic valueSevere gradesMedical recordsClinical Correlates of Periodic Discharges and Nonconvulsive Seizures in Posterior Reversible Encephalopathy Syndrome (PRES)
Bastide L, Legros B, Rampal N, Gilmore EJ, Hirsch LJ, Gaspard N. Clinical Correlates of Periodic Discharges and Nonconvulsive Seizures in Posterior Reversible Encephalopathy Syndrome (PRES). Neurocritical Care 2018, 29: 481-490. PMID: 29949000, DOI: 10.1007/s12028-018-0548-2.Peer-Reviewed Original ResearchConceptsPosterior reversible encephalopathy syndromeReversible encephalopathy syndromeContinuous electroencephalography monitoringGlasgow Outcome ScaleNonconvulsive seizuresPeriodic dischargesEncephalopathy syndromeRisk factorsWorse outcomesEpileptiform patternsMagnetic resonance imaging (MRI) abnormalitiesRetrospective cohort studyCEEG findingsEligible patientsRelated seizuresCohort studyHospital dischargeLow disabilityIll patientsImaging abnormalitiesMedical chartsClinical featuresPathophysiological mechanismsEEG findingsFunctional outcome
2015
Prognostication 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
2010
Urgent Continuous EEG (cEEG) Monitoring Leads to Changes in Treatment in Half of Cases
Hirsch LJ. Urgent Continuous EEG (cEEG) Monitoring Leads to Changes in Treatment in Half of Cases. Epilepsy Currents 2010, 10: 82-85. PMID: 20697500, PMCID: PMC2912537, DOI: 10.1111/j.1535-7511.2010.01364.x.Peer-Reviewed Original ResearchContinuous electroencephalographic monitoringIntensive care unitAED therapyElectroencephalographic monitoringCare unitElectrographic seizuresNeuroscience intensive care unitAntiepileptic drug therapyRetrospective cohort studyContinuous EEG monitoringAED prescribingAntiepileptic medicationsCohort studyElectroencephalographic findingsNeurological wardDrug therapyElectroencephalographic abnormalitiesInpatient settingAED changesEEG monitoringTherapySeizuresIndividual inpatientsPrescribingFindings
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