2020
Neuroimaging Correlates of Lateralized Rhythmic Delta Activity, Lateralized Periodic Discharges, and Generalized Rhythmic Delta Activity on EEG in Critically Ill Patients
Alzawahmah M, Fong MWK, Gilmore EJ, Hirsch LJ. Neuroimaging Correlates of Lateralized Rhythmic Delta Activity, Lateralized Periodic Discharges, and Generalized Rhythmic Delta Activity on EEG in Critically Ill Patients. Journal Of Clinical Neurophysiology 2020, 39: 228-234. PMID: 33235178, DOI: 10.1097/wnp.0000000000000763.Peer-Reviewed Original ResearchConceptsRhythmic delta activityDelta activityMRI abnormalitiesNormal MRIGeneralized rhythmic delta activityLateralized rhythmic delta activityLateralized periodic dischargesCritically Ill PatientsMajority of patientsMultifocal abnormalitiesIll patientsFocal findingsMRI characteristicsFocal abnormalitiesLRDAPatientsDiscordant findingsEpileptiform patternsMost abnormalitiesContinuous EEGPeriodic dischargesAbnormalitiesEEG patternsStatistical significanceMRIDiagnostic Value of Electroencephalography with Ten Electrodes in Critically Ill Patients
Westover MB, Gururangan K, Markert MS, Blond BN, Lai S, Benard S, Bickel S, Hirsch LJ, Parvizi J. Diagnostic Value of Electroencephalography with Ten Electrodes in Critically Ill Patients. Neurocritical Care 2020, 33: 479-490. PMID: 32034656, PMCID: PMC7416437, DOI: 10.1007/s12028-019-00911-4.Peer-Reviewed Original ResearchConceptsDiagnostic valueAncillary clinical informationCritical care settingMassachusetts General HospitalGold standard diagnosisSame raterIll patientsSeizure activityGeneral HospitalIntra-rater agreementCare settingsHospital cliniciansClinical informationInter-rater variabilitySeizuresStandard diagnosisPathological activityEEG patternsPhase IGold standardHigh concordancePhase IIElectroencephalographyDiagnosisPresent study
2018
Seizures, periodic and rhythmic patterns in primary intraventricular hemorrhage
Stretz C, Sheikh Z, Maciel CB, Hirsch LJ, Gilmore EJ. Seizures, periodic and rhythmic patterns in primary intraventricular hemorrhage. Annals Of Clinical And Translational Neurology 2018, 5: 1104-1111. PMID: 30250866, PMCID: PMC6144442, DOI: 10.1002/acn3.627.Peer-Reviewed Original ResearchPrimary intraventricular hemorrhageFrequency of seizuresIctal-interictal continuumAntiseizure medicationsIntraventricular hemorrhageCEEG monitoringExternal ventricular drain placementPresence of hydrocephalusRhythmic EEG patternsVentricular drain placementCEEG durationCEEG patternsMedian ageNeuronal injuryElectrographic seizuresDrain placementRisk factorsOnly significant differenceGraeb scoreContinuous electroencephalographyCEEG recordingsSeizuresPatientsPeriodic dischargesEEG patterns
2014
Interrater agreement for Critical Care EEG Terminology
Gaspard N, Hirsch LJ, LaRoche SM, Hahn CD, Westover MB, Consortium T. Interrater agreement for Critical Care EEG Terminology. Epilepsia 2014, 55: 1366-1373. PMID: 24888711, PMCID: PMC4879939, DOI: 10.1111/epi.12653.Peer-Reviewed Original ResearchConceptsCritical care EEG terminologyEEG terminologyClinical significanceInterrater agreementAmerican Clinical Neurophysiology SocietyUncertain clinical significanceSupporting Information sectionElectrographic seizuresTriphasic morphologyHigh interrater agreementMulticenter researchEEG patternsSeizuresElectroencephalography studyStandardized terminologyInformation sectionIdentical questionsTraining slidesWeb-based testEEG samples
2013
Similarity of Lateralized Rhythmic Delta Activity to Periodic Lateralized Epileptiform Discharges in Critically Ill Patients
Gaspard N, Manganas L, Rampal N, Petroff OA, Hirsch LJ. Similarity of Lateralized Rhythmic Delta Activity to Periodic Lateralized Epileptiform Discharges in Critically Ill Patients. JAMA Neurology 2013, 70: 1288-1295. PMID: 23921464, DOI: 10.1001/jamaneurol.2013.3475.Peer-Reviewed Original ResearchConceptsLateralized rhythmic delta activityRhythmic delta activityContinuous EEG monitoringIll patientsDelta activityPeriodic dischargesAcute seizuresClinical significanceIll subjectsEEG monitoringEEG patternsPeriodic lateralized epileptiform dischargesJuxtacortical white matterContinuous electroencephalography monitoringIntensive care unitCross-sectional prevalenceFocal EEG abnormalitiesAcademic medical centerSimilar clinical significanceRadiological correlatesEarly seizuresMost patientsAcute illnessDischarge groupIndependent predictorsPitfalls in ictal EEG interpretation
Gaspard N, Hirsch LJ. Pitfalls in ictal EEG interpretation. Neurology 2013, 80: s26-s42. PMID: 23267042, DOI: 10.1212/wnl.0b013e31827974f8.Peer-Reviewed Original Research
2011
Classification of EEG patterns in patients with impaired consciousness
Hirsch LJ. Classification of EEG patterns in patients with impaired consciousness. Epilepsia 2011, 52: 21-24. PMID: 21967354, DOI: 10.1111/j.1528-1167.2011.03228.x.Peer-Reviewed Original Research
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 advancesIschemiaInjuryPrognosticationImpairmentWhich 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 recommendationsDischargePatientsEtiologyInjuryDiagnosisThe ACNS Subcommittee on Research Terminology for Continuous EEG Monitoring: Proposed Standardized Terminology for Rhythmic and Periodic EEG Patterns Encountered in Critically Ill Patients
Hirsch LJ, Brenner RP, Drislane FW, So E, Kaplan PW, Jordan KG, Herman ST, LaRoche SM, Young B, Bleck TP, Scheuer ML, Emerson RG. The ACNS Subcommittee on Research Terminology for Continuous EEG Monitoring: Proposed Standardized Terminology for Rhythmic and Periodic EEG Patterns Encountered in Critically Ill Patients. Journal Of Clinical Neurophysiology 2005, 22: 128-135. PMID: 15805813, DOI: 10.1097/01.wnp.0000158701.89576.4c.Peer-Reviewed Original Research
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 difficultiesStimulus‐induced Rhythmic, Periodic, or Ictal Discharges (SIRPIDs): A Common EEG Phenomenon in the Critically Ill
Hirsch LJ, Claassen J, Mayer SA, Emerson RG. Stimulus‐induced Rhythmic, Periodic, or Ictal Discharges (SIRPIDs): A Common EEG Phenomenon in the Critically Ill. Epilepsia 2004, 45: 109-123. PMID: 14738418, DOI: 10.1111/j.0013-9580.2004.38103.x.Peer-Reviewed Original ResearchConceptsContinuous EEG monitoringIctal dischargesEEG patternsClinical status epilepticusAcute brain injuryPeriodic epileptiform dischargesEEG phenomenaPrior epilepsyEncephalopathic patientsAcute illnessClinical seizuresConsecutive patientsIll patientsSpontaneous seizuresStatus epilepticusPatients stimulationBrain injuryEpileptiform dischargesSIRPIDsPatientsEEG monitoringTherapeutic significanceSeizuresSignificant differencesStimulationContinuous EEG Monitoring in the Intensive Care Unit: An Overview
Hirsch LJ. Continuous EEG Monitoring in the Intensive Care Unit: An Overview. Journal Of Clinical Neurophysiology 2004, 21: 332-340. PMID: 15592007, DOI: 10.1097/01.wnp.0000147129.80917.0e.Peer-Reviewed Original ResearchConceptsPeriodic epileptiform dischargesComatose patientsEpileptiform dischargesEEG patternsIntensive care unitLevel of sedationContinuous EEG monitoringMajority of seizuresHospital infarctionNoncomatose patientsRecent neurosurgeryClinical seizuresCNS infectionICU patientsIll patientsNonconvulsive seizuresCare unitWorse outcomesAutonomic changesParoxysmal spellsBrain tumorsPatientsEEG monitoringEEG trendsSeizures
2002
The current state of treatment of status epilepticus
Hirsch LJ, Claassen J. The current state of treatment of status epilepticus. Current Neurology And Neuroscience Reports 2002, 2: 345-356. PMID: 12044254, DOI: 10.1007/s11910-002-0010-9.Peer-Reviewed Original ResearchConceptsStatus epilepticusRefractory status epilepticusConvulsive status epilepticusNonconvulsive status epilepticusCertain EEG patternsAmbulatory patientsConfusional stateIll patientsClinical trialsEarly treatmentAnesthetic agentsEpilepticusClinical careEEG patternsPatientsTreatmentElectroencephalogram (EEG) recordingsMidazolamPropofolDiagnosis