10 research outputs found
Artifacts
No full textThe term “artifact” refers to any element of extra-cerebral origin which can be recorded in the EEG channels, disturbing the acquisition of the tracing. Artifacts may derive from many sources, internal or external to the patient, and have several characteristics that may suggest their origin. Both the technician and the physician should be able to recognize the artifacts, for the possibility of misinterpreting the examination. As a matter of fact, even though many artifacts are easily detectable, some may remind pathological graphoelements and, therefore, be the cause for incorrect EEG interpretation. However, some artifacts are not considered a disturbance in the EEG recording, and they are instead considered useful for its interpretation. For example, eye movement artifacts, due to their typical morphology and localization, provide immediate information on the correct position of the electrodes, amplification parameters, and the patient’s emotional state and alertness; they are also useful in identifying the sleep stages. Sometimes, the ECG artifact can reveal cardiac arrhythmias. In epileptic patients, the appearance of muscular, ocular, or movement artifacts may indicate the seizure onset. In this chapter, the most common artifacts will be described, to give physicians and technicians the tools to detect and - possibility - to avoid their recording
Neuromonitoring and Emergency EEG
No full textIntraoperative and Intensive Care Unit (ICU) EEG monitoring is very useful in cases of possible brain damage, for example, during carotid endarterectomy, cardiac surgery and neurosurgery, or when subclinical seizures are suspected. Continuous EEG (cEEG) monitoring during surgery is a valid and sensitive instrument for recognizing and/or preventing perioperative ischemic insults or any epileptiform activity responsible for convulsive or nonconvulsive symptoms. Furthermore, it allows brain functions monitoring for anesthetic drug administration, to determine the depth of anesthesia and for adjusting drug levels to achieve a predefined neural effect, such as burst suppression. In ICU, cEEG monitoring is essential to identify electrical discharges that occur frequently in critically ill patients and that are often clinically undetected, but potentially harmful if the diagnosis and the treatment are delayed. In the last years, cEEG monitoring has become a widespread practice, especially because of the use of new digital equipments, which are extremely compact and easy to use, not requiring a constant connection to the power grid and thus avoiding artifacts. EEG tracings can be visualized in real-time or analyzed after acquisition, either online or offline, with qualitative and/or quantitative methods. Finally, it is worth remembering that EEGs can be recorded bedside from a peripheral recording unit and then sent to the central unit, so that neurophysiologists can examine the recordings from distance and process them without interfering with the patients’ management
Scuba Diving Is Not Associated With High Prevalence of Headache: A Cross-Sectional Study in Men
No full textObjective. To study the prevalence of cephalalgia in male divers. Background.-Scuba divers work in stressing environments and have a high cerebrovascular risk, both conditions which are supposed to contribute to the genesis of cephalalgia. However, no study assessed expressly the prevalence of cephalalgia in divers, to date. Methods.-We enrolled 201 professional male scuba divers (41.0 +/- 7.2 years) and controls (41.1 +/- 7.2 years), and the risk ratio and its corresponding 95% confidence of suffering from cephalalgia was calculated. Results.-We found that 16% of divers and 22% of matched controls were affected by cephalalgia (P>.05), accounting for a risk ratio of 0.71 (95% CI 0.47-1.07). Divers reported fewer attacks per month (1.8 +/- 0.7, n = 32) with regard to controls (2.5 +/- 1.8, n = 45) (P=.02), but no differences concerning age at onset and severity were detected (P>.05). Divers suffered from migraine, migraine with aura and tension headache as much as controls. Conclusion.-Scuba diving, an intense physical activity characterized by cerebral micro-vascular distress, is not associated with cephalalgia, as a whole, or migraine, tension headache or migraine with aura, more commonly than in a matched, non-diving, population. A longitudinal study may disclose if diving may act as a protective factor in the occurrence of crises of cephalalgia
Effects of eslicarbazepine acetate on lipid profile and sodium levels in patients with epilepsy
No full textSeveral studies have demonstrated that treatment with enzyme-inducing antiepileptic drugs is associated with increased serum lipid levels. Eslicarbazepine acetate (ESL) is a novel antiepileptic drug specifically designed with the objective to identify carbamazepine and oxcarbazepine analogues with favorable pharmacodynamic and pharmacokinetic profiles. The present study aimed to assess the changes in lipid profile and sodium levels in patients with epilepsy taking ESL as adjunctive therapy
Effect of 24-h continuous rotigotine treatment on stationary and non-stationary locomotion in de novo patients with Parkinson disease in an open-label uncontrolled study
No full textThe aim of this study was to investigate the effect of a rotigotine transdermal patch on stationary and non-stationary locomotion in de novo Parkinson disease (PD) patients in an open-label uncontrolled study. A 3-D gait analysis system was used to investigate four different locomotor tasks: steady-state linear walking, gait initiation, gait termination and 180°-turning. A series of gait variables were measured for each locomotor task. PD patients who received rotigotine treatment (4-8 mg) displayed: (1) increased step length, gait speed, cadence and arm oscillations, and reduced double support duration and step asymmetry during steady-state linear gait; (2) increased initial step length during gait initiation; (3) increased final step length and gait speed, and decreased stability index during gait termination; (4) decreased duration of turning and head-pelvis delays during 180°-turning. The main finding that emerges from the present study is that the dopamine agonist rotigotine can improve various aspects of gait in de novo PD patients
Eslicarbazepine acetate modulates eeg activity and connectivity in focal epilepsy
No full textIntroduction: Eslicarbazepine acetate (ESL) is an antiepileptic drug approved as monotherapy or add-on for the treatment of epilepsy with seizures of focal onset. ESL owns a good profile in terms of efficacy and tolerability, but its effects on EEG activity and connectivity are unknown. The purpose of this study was to investigate EEG activity and connectivity changes after ESL treatment in persons with focal epilepsy (PFE). Material andMethods: We performed a multicentre, longitudinal, retrospective, quantitative EEG study on a population of 22 PFE, and a group of 40 controls. We investigated the ESL-related changes of EEG power spectral activity and global connectivity [phase locking value (PLV), amplitude envelope correlation (AEC) and amplitude envelope correlation of orthogonalized signals (Ortho-AEC)] for standard frequency bands (delta to gamma). Seizure frequency was evaluated to assess ESL efficacy in our cohort.Results: ESL significantly enhanced both global power spectral density and connectivity for all frequency bands, similarly for all connectivity measures. When compared to the control group, Post-ESL power was significantly higher in theta and gamma band. Pre-ESL connectivity values were significantly lower than control for all frequency bands. Post-ESL connectivity increased and the gap between the two groups was no longer significant. ESL induced a 52.7 +/- 41.1% reduction of seizure frequency, with 55% of clinical responders (reduction of seizures >= 50%).Discussion: ESL therapy induces significant enhancement of brain activity and connectivity. Post-ESL connectivity profile of epilepsy patients was similar to the one of healthy controls
The contribution of trigemino-cervical reflexes in distinguishing progressive supranuclear palsy from multiple system atrophy
No full textOBJECTIVE: Trigemino-cervical reflexes (TCRs) are electromyographic responses induced by electrical stimulation of the trigeminal nerve and recorded in the neck muscles. Trigemino-cervical reflexes are detectable in Parkinson's disease, whereas they are absent in progressive supranuclear palsy (PSP), an atypical parkinsonism associated with brainstem degeneration. To date, no study has investigated TCRs in multiple system atrophy (MSA), another atypical parkinsonism associated with brainstem involvement, which resembles PSP.
METHODS:
To understand whether TCRs are helpful in differentiating PSP from MSA, we compared the TCRs recorded in 10 PSP patients with those obtained from 10 patients diagnosed as having probable MSA, parkinsonian type (MSA-P).
RESULTS:
Trigemino-cervical reflexes were not recorded in any of the PSP patients, while they were clearly detectable in all the MSA-P patients.
CONCLUSIONS:
Trigemino-cervical reflex recording is a rapid neurophysiological method, which could assist in the differential diagnosis between PSP and MSA-P.
SIGNIFICANCE:
This study further improves our understanding of the different neuronal functioning of extrapyramidal disorders. TCRs monitoring may be useful to support the diagnosis of atypical parkinsonisms especially when clinical evidence is uncertain
