2024
Immediate and long‐term management practices of acute symptomatic seizures and epileptiform abnormalities: A cross‐sectional international survey
Punia V, Daruvala S, Dhakar M, Zafar S, Rubinos C, Ayub N, Hirsch L, Sivaraju A, investigators F. Immediate and long‐term management practices of acute symptomatic seizures and epileptiform abnormalities: A cross‐sectional international survey. Epilepsia 2024, 65: 909-919. PMID: 38358383, DOI: 10.1111/epi.17915.Peer-Reviewed Original ResearchAnti-seizure medicationsEpileptiform abnormalitiesAcute symptomatic seizuresAcute brain injuryContinuous EEGSecondary prophylaxisSymptomatic seizuresSporadic epileptiform dischargesLateralized periodic dischargesCross-sectional international surveyOutpatient follow-upAnti-seizure medication useOptimal care pathwayDose escalationBrain injuryDose changesLong-term managementElectrographic seizuresEpileptiform dischargesFollow-upAncillary testsReal-world practiceRecommended durationContinuous electroencephalographyHospital discharge
2021
High epileptiform discharge burden predicts delayed cerebral ischemia after subarachnoid hemorrhage
Kim JA, Zheng WL, Elmer J, Jing J, Zafar SF, Ghanta M, Moura V, Gilmore EJ, Hirsch LJ, Patel A, Rosenthal E, Westover MB. High epileptiform discharge burden predicts delayed cerebral ischemia after subarachnoid hemorrhage. Clinical Neurophysiology 2021, 141: 139-146. PMID: 33812771, PMCID: PMC8429508, DOI: 10.1016/j.clinph.2021.01.022.Peer-Reviewed Original ResearchConceptsED burdenSubarachnoid hemorrhageEpileptiform dischargesCerebral ischemiaSAH patientsHigh riskOnset of DCIMajor risk periodContinuous EEG recordingsDCI patientsDCI riskRetrospective analysisNovel biomarkersGroup-based trajectory analysisRisk periodPatientsDay 3.5DCIBurdenHemorrhageIschemiaRiskEEG recordingsBurden rateUseful parameter
2017
Brief 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 recordings
2016
Development and Feasibility Testing of a Critical Care EEG Monitoring Database for Standardized Clinical Reporting and Multicenter Collaborative Research
Lee JW, LaRoche S, Choi H, Ruiz A, Fertig E, Politsky JM, Herman ST, Loddenkemper T, Sansevere AJ, Korb PJ, Abend NS, Goldstein JL, Sinha SR, Dombrowski KE, Ritzl EK, Westover MB, Gavvala JR, Gerard EE, Schmitt SE, Szaflarski JP, Ding K, Haas KF, Buchsbaum R, Hirsch LJ, Wusthoff CJ, Hopp JL, Hahn CD. Development and Feasibility Testing of a Critical Care EEG Monitoring Database for Standardized Clinical Reporting and Multicenter Collaborative Research. Journal Of Clinical Neurophysiology 2016, 33: 133-140. PMID: 26943901, PMCID: PMC4878836, DOI: 10.1097/wnp.0000000000000230.Peer-Reviewed Original ResearchConceptsCritical Care EEG Monitoring Research ConsortiumAmerican Clinical Neurophysiology SocietyIncidence of seizuresMulticenter feasibility studyIntensive care unitLarge-volume centersInterictal epileptiform dischargesDaily clinical useMulticenter collaborative researchCare unitUnique patientsVolume centersElectroencephalogram monitoringDuration of recordingEpileptiform dischargesMulticenter research studiesRhythmic dischargesClinical reportsResearch DatabaseEEG monitoringClinical data repositoryClinical useConsortium databaseEEG reportsReporting tools
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
2014
The spatial and signal characteristics of physiologic high frequency oscillations
Alkawadri R, Gaspard N, Goncharova II, Spencer DD, Gerrard JL, Zaveri H, Duckrow RB, Blumenfeld H, Hirsch LJ. The spatial and signal characteristics of physiologic high frequency oscillations. Epilepsia 2014, 55: 1986-1995. PMID: 25470216, PMCID: PMC5123742, DOI: 10.1111/epi.12851.Peer-Reviewed Original ResearchConceptsPhysiologic high-frequency oscillationsSeizure onsetEpileptic networkNon-rapid eye movement sleepComprehensive Epilepsy CenterMesial temporal structuresEye movement sleepHighest HFO ratesHigh-frequency oscillationsFirst seizureInvasive evaluationEpilepsy centersIntracranial evaluationMovement sleepPerirolandic regionEpileptiform dischargesParietooccipital regionOccipital lobeEpileptic sitesPatientsNonepileptic regionsPhysiologic eventsFast ripplesHFO ratesLonger duration
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 evaluation
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
Frequency and Predictors of Nonconvulsive Seizures During Continuous Electroencephalographic Monitoring in Critically Ill Children
Jette N, Claassen J, Emerson RG, Hirsch LJ. Frequency and Predictors of Nonconvulsive Seizures During Continuous Electroencephalographic Monitoring in Critically Ill Children. JAMA Neurology 2006, 63: 1750-1755. PMID: 17172615, DOI: 10.1001/archneur.63.12.1750.Peer-Reviewed Original ResearchConceptsContinuous electroencephalographic monitoringPeriodic lateralized epileptiform dischargesNonconvulsive seizuresIll childrenElectroencephalographic monitoringEpileptiform dischargesMultivariate logistic regression analysisMajority of patientsLogistic regression analysisAbsence of reactivityCEEG initiationClinical seizuresStatus epilepticusPrior seizuresSeizuresMultivariate analysisFirst hourChildrenPatientsRegression analysisBackground reactivityHoursPredictorsHours of recordingsEpilepticusNonconvulsive Status Epilepticus in Children: Clinical and EEG Characteristics
Tay SK, Hirsch LJ, Leary L, Jette N, Wittman J, Akman CI. Nonconvulsive Status Epilepticus in Children: Clinical and EEG Characteristics. Epilepsia 2006, 47: 1504-1509. PMID: 16981867, DOI: 10.1111/j.1528-1167.2006.00623.x.Peer-Reviewed Original ResearchConceptsNonconvulsive status epilepticusConvulsive status epilepticusPeriodic lateralized epileptiform dischargesPediatric patientsStatus epilepticusEpileptiform dischargesDiagnosis of NCSEAcute hypoxic-ischemic injuryAntiepileptic drug regimenAcute medical illnessHypoxic-ischemic injuryComprehensive Epilepsy CenterContinuous electroencephalographic monitoringPeriodic epileptiform dischargesHeterogeneous clinical conditionYears of ageFrequent etiologyNeurological outcomeChart reviewDrug regimenAcute infectionAcute settingConvulsive seizuresPrompt recognitionRefractory epilepsyPrognostic 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
2005
Which 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 recommendationsDischargePatientsEtiologyInjuryDiagnosis
2004
Stimulus‐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
Video‐EEG Monitoring in the Elderly: A Review of 94 Patients
McBride AE, Shih TT, Hirsch LJ. Video‐EEG Monitoring in the Elderly: A Review of 94 Patients. Epilepsia 2002, 43: 165-169. PMID: 11903463, DOI: 10.1046/j.1528-1157.2002.24401.x.Peer-Reviewed Original ResearchConceptsVideo-EEG monitoringMajority of patientsNonepileptic eventsPsychogenic seizuresPatient admissionsEpileptiform dischargesColumbia-Presbyterian Medical CenterEpilepsy monitoring unitInterictal epileptiform dischargesAntiepileptic medicationsElderly patientsIncreased incidenceDefinitive diagnosisDiagnostic evaluationNonepileptic seizuresMedical CenterElderly populationPatientsAverage ageEpileptic seizuresInterictal recordingsSeizuresElderly leadsAge groupsParoxysmal events