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
Quantitative Electroencephalogram Trends Predict Recovery in Hypoxic-Ischemic Encephalopathy.
Ghassemi MM, Amorim E, Alhanai T, Lee JW, Herman ST, Sivaraju A, Gaspard N, Hirsch LJ, Scirica BM, Biswal S, Moura Junior V, Cash SS, Brown EN, Mark RG, Westover MB. Quantitative Electroencephalogram Trends Predict Recovery in Hypoxic-Ischemic Encephalopathy. Critical Care Medicine 2019, 47: 1416-1423. PMID: 31241498, PMCID: PMC6746597, DOI: 10.1097/ccm.0000000000003840.Peer-Reviewed Original ResearchConceptsHypoxic-ischemic encephalopathyNeurologic outcomeElectroencephalogram featuresAcute hypoxic-ischemic encephalopathyAcademic medical centerBetter prognostic predictionReceiver operator curveNeurologic recoveryComatose patientsPrognostic implicationsCardiac arrestMedical CenterPrognostication performancePrognostic predictionOperator curveLogistic regressionSequential logistic regressionSpecificity thresholdEncephalopathyStatistical associationOutcomes
2017
Association of Periodic and Rhythmic Electroencephalographic Patterns With Seizures in Critically Ill Patients
Ruiz A, Vlachy J, Lee JW, Gilmore EJ, Ayer T, Haider HA, Gaspard N, Ehrenberg JA, Tolchin B, Fantaneanu TA, Fernandez A, Hirsch LJ, LaRoche S. Association of Periodic and Rhythmic Electroencephalographic Patterns With Seizures in Critically Ill Patients. JAMA Neurology 2017, 74: 181-188. PMID: 27992625, DOI: 10.1001/jamaneurol.2016.4990.Peer-Reviewed Original ResearchConceptsRhythmic delta activityDelta activityPeriodic dischargesIll patientsSeizure riskElectroencephalographic patternsStimulation-induced patternsCritically Ill PatientsRisk of seizuresHigher seizure riskAcademic medical centerFrequency-dependent mannerSeizure incidenceIll adultsRisk stratificationHigh prevalenceMedical CenterMAIN OUTCOMEContinuous electroencephalographySeizuresPattern prevalenceMultivariate analysisPatientsClinical decisionRhythmic patterns
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 overAnestheticsAnti-N-Methyl-D-Aspartate Receptor EncephalitisAnticonvulsantsAutoantibodiesCohort 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 statusAcute brain failure in severe sepsis: a prospective study in the medical intensive care unit utilizing continuous EEG monitoring
Gilmore EJ, Gaspard N, Choi HA, Cohen E, Burkart KM, Chong DH, Claassen J, Hirsch LJ. Acute brain failure in severe sepsis: a prospective study in the medical intensive care unit utilizing continuous EEG monitoring. Intensive Care Medicine 2015, 41: 686-694. PMID: 25763756, DOI: 10.1007/s00134-015-3709-1.Peer-Reviewed Original ResearchConceptsNonconvulsive seizuresSevere sepsisEEG reactivityPeriodic dischargesLate seizuresSOFA scoreAPACHE IIFunctional outcomeContinuous sedationHigh riskLower riskMedical intensive care unitLong-term cognitive outcomesPresence of sedationAPACHE II scoreGood functional outcomeNonconvulsive status epilepticusIntensive care unitContinuous EEG monitoringAcute brain failureAcademic medical centerNew epilepsyII scoreClinical seizuresMedical ICU
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 predictorsIntravenous ketamine for the treatment of refractory status epilepticus: A retrospective multicenter study
Gaspard N, Foreman B, Judd LM, Brenton JN, Nathan BR, McCoy BM, Al‐Otaibi A, Kilbride R, Fernández IS, Mendoza L, Samuel S, Zakaria A, Kalamangalam GP, Legros B, Szaflarski JP, Loddenkemper T, Hahn CD, Goodkin HP, Claassen J, Hirsch LJ, LaRoche SM. Intravenous ketamine for the treatment of refractory status epilepticus: A retrospective multicenter study. Epilepsia 2013, 54: 1498-1503. PMID: 23758557, PMCID: PMC3731413, DOI: 10.1111/epi.12247.Peer-Reviewed Original ResearchConceptsRefractory status epilepticusTreatment of RSEIntravenous ketamineStatus epilepticusBrain injuryEpisodes of RSEPostanoxic brain injuryAnoxic brain injuryMulticenter retrospective reviewRetrospective multicenter studyRole of ketaminePossible adverse eventsAcademic medical centerKetamine initiationProspective trialAdverse eventsRetrospective reviewRetrospective seriesSE onsetMulticenter studyLast drugMedical recordsMedical CenterSafe drugConcurrent drugs
2012
Extreme delta brush
Schmitt SE, Pargeon K, Frechette ES, Hirsch LJ, Dalmau J, Friedman D. Extreme delta brush. Neurology 2012, 79: 1094-1100. PMID: 22933737, PMCID: PMC3525298, DOI: 10.1212/wnl.0b013e3182698cd8.Peer-Reviewed Original ResearchConceptsExtreme delta brushAnti-NMDAR encephalitisDelta brushCEEG monitoringAdult patientsAnti-NMDA receptor encephalitisExtreme delta brush patternModified Rankin Scale scoreRankin Scale scoreLarge academic medical centerAcademic medical centerContinuous EEG patternReceptor encephalitisPremature infantsProlonged hospitalizationCommon symptomsMedian lengthEEG findingsElectrographic patternsProlonged illnessMovement disordersMedical CenterPatientsScale scoreEncephalitis