The influence of tDCS intensity on decision-making training and transfer outcomes, Journal of Neurophysiology, Volume 125, Issue 2, Page 385-397, February 2021. , Journal of Neurophysiology, Volume 125, Issue 2, Page 385-397, February 2021.
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An Evaluation of the Channel Effect on Detecting the Preictal Stage in Patients With Epilepsy
An Evaluation of the Channel Effect on Detecting the Preictal Stage in Patients With Epilepsy, Clinical EEG and Neuroscience, Ahead of Print. Decreasing the processor load to an acceptable level challenges researchers as an important threshold in the study of real-time detection and the prediction of epileptic seizures. The main methods in overcoming this problem are feature selection, dimension reduction, and electrode selection., Clinical EEG and Neuroscience, Ahead of Print.
Decreasing the processor load to an acceptable level challenges researchers as an important threshold in the study of real-time detection and the prediction of epileptic seizures. The main methods in overcoming this problem are feature selection, dimension reduction, and electrode selection. This study is an evaluation of the performances of EEG signals, obtained from different channels in the detection processes of epileptic stages, in epileptic individuals. In particular, it aimed to analyze the separation levels of preictal periods from other periods and to evaluate the effects of the electrode selection on seizure prediction studies. The EEG signals belong to 14 epileptic patients. A feature set was formed for each patient using 20 features widely used in epilepsy studies. The number of features was decreased to 8 using principal component analysis. The reduced feature set was divided into testing and training data, using the cross-validation method. The testing data were classified with linear discriminant analysis and the results of the classification were evaluated individually for each patient and channel. Variability of up to 29.48 % was observed in the average of classification accuracy due to the selection of channels., admin,
Decreasing the processor load to an acceptable level challenges researchers as an important threshold in the study of real-time detection and the prediction of epileptic seizures. The main methods in overcoming this problem are feature selection, dimension reduction, and electrode selection. This study is an evaluation of the performances of EEG signals, obtained from different channels in the detection processes of epileptic stages, in epileptic individuals. In particular, it aimed to analyze the separation levels of preictal periods from other periods and to evaluate the effects of the electrode selection on seizure prediction studies. The EEG signals belong to 14 epileptic patients. A feature set was formed for each patient using 20 features widely used in epilepsy studies. The number of features was decreased to 8 using principal component analysis. The reduced feature set was divided into testing and training data, using the cross-validation method. The testing data were classified with linear discriminant analysis and the results of the classification were evaluated individually for each patient and channel. Variability of up to 29.48 % was observed in the average of classification accuracy due to the selection of channels., admin,
Long-lasting changes in muscle activation and step cycle variables induced by repetitive sensory stimulation...
Long-lasting changes in muscle activation and step cycle variables induced by repetitive sensory stimulation..., Journal of Neurophysiology, Volume 125, Issue 2, Page 331-343, February 2021. , Journal of Neurophysiology, Volume 125, Issue 2, Page 331-343, February 2021.
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Clinical Correlates of Electroencephalographic Patterns in Critically Ill Patients
Clinical Correlates of Electroencephalographic Patterns in Critically Ill Patients, Clinical EEG and Neuroscience, Ahead of Print. ObjectiveThe objective of this study was to determine the frequency and clinical correlates of different electroencephalographic patterns and their association with clinical outcomes in critically ill patients., Clinical EEG and Neuroscience, Ahead of Print.
ObjectiveThe objective of this study was to determine the frequency and clinical correlates of different electroencephalographic patterns and their association with clinical outcomes in critically ill patients.Subjects and MethodsThis retrospective cross-sectional study was performed in the Neurology Department of King Fahd Hospital of the University, Kingdom of Saudi Arabia and involved a review and analysis of medical records pertaining to 179 intensive care unit patients who underwent electroencephalography (EEG) in the June to November 2018 period.ResultsAmong the different etiologies, presence of spike and wave or sharp wave (SWs) was associated with encephalitis (P = .01) and large artery stroke (P = .01), whereas markedly attenuated EEG activity (p = .04) and burst suppression (P = .01) were associated with large artery stroke and hypoxic ischemic encephalopathy (HIE), respectively. Generalized theta activity (P = .01) was significantly found in patients of septic encephalopathy, while generalized delta activity (P = .02) and asymmetrical background (P = .04) were significantly associated with traumatic brain injury. Presence of periodic discharges in EEG was significantly associated with more adverse clinical outcomes (P = .001), whereas rhythmic delta activity (RDA) (P = .03), persistent focal slow wave activity (P = .01), and asymmetric background (P = .002) were found in patients who were discharged from hospital with sequelae of current illness.ConclusionCertain EEG patterns are associated with particular underlying etiologies like SWs for encephalitis, markedly attenuated EEG activity and burst suppression with large artery stroke and HIE, respectively. Whereas few EEG patterns, including periodic discharges, RDA, persistent focal slow wave activity have some prognostic value in critically ill patients. However, they cannot be used as markers for prognostic assessment of patients without considering other clinical and diagnostic variables. Further larger prospective studies with continuous EEG monitoring with control of confounding factors are needed., admin,
ObjectiveThe objective of this study was to determine the frequency and clinical correlates of different electroencephalographic patterns and their association with clinical outcomes in critically ill patients.Subjects and MethodsThis retrospective cross-sectional study was performed in the Neurology Department of King Fahd Hospital of the University, Kingdom of Saudi Arabia and involved a review and analysis of medical records pertaining to 179 intensive care unit patients who underwent electroencephalography (EEG) in the June to November 2018 period.ResultsAmong the different etiologies, presence of spike and wave or sharp wave (SWs) was associated with encephalitis (P = .01) and large artery stroke (P = .01), whereas markedly attenuated EEG activity (p = .04) and burst suppression (P = .01) were associated with large artery stroke and hypoxic ischemic encephalopathy (HIE), respectively. Generalized theta activity (P = .01) was significantly found in patients of septic encephalopathy, while generalized delta activity (P = .02) and asymmetrical background (P = .04) were significantly associated with traumatic brain injury. Presence of periodic discharges in EEG was significantly associated with more adverse clinical outcomes (P = .001), whereas rhythmic delta activity (RDA) (P = .03), persistent focal slow wave activity (P = .01), and asymmetric background (P = .002) were found in patients who were discharged from hospital with sequelae of current illness.ConclusionCertain EEG patterns are associated with particular underlying etiologies like SWs for encephalitis, markedly attenuated EEG activity and burst suppression with large artery stroke and HIE, respectively. Whereas few EEG patterns, including periodic discharges, RDA, persistent focal slow wave activity have some prognostic value in critically ill patients. However, they cannot be used as markers for prognostic assessment of patients without considering other clinical and diagnostic variables. Further larger prospective studies with continuous EEG monitoring with control of confounding factors are needed., admin,
The effects of a spaceflight analog with elevated CO2 on sensorimotor adaptation
The effects of a spaceflight analog with elevated CO2 on sensorimotor adaptation, Journal of Neurophysiology, Volume 125, Issue 2, Page 426-436, February 2021. , Journal of Neurophysiology, Volume 125, Issue 2, Page 426-436, February 2021.
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Added Value of QEEG for the Differential Diagnosis of Common Forms of Dementia
Added Value of QEEG for the Differential Diagnosis of Common Forms of Dementia, Clinical EEG and Neuroscience, Ahead of Print. IntroductionQuantitative electroencephalography (QEEG) has been documented as a helpful tool in the differential diagnosis of Alzheimer’s disease (AD) with common forms of dementia., Clinical EEG and Neuroscience, Ahead of Print.
IntroductionQuantitative electroencephalography (QEEG) has been documented as a helpful tool in the differential diagnosis of Alzheimer’s disease (AD) with common forms of dementia. The main objective of the study was to assess the role of QEEG in AD differential diagnosis with other forms of dementia: Lewy body dementia (LBD), Parkinson’s disease dementia (PDD), frontotemporal dementia (FTD), and vascular dementia (VaD).MethodsWe searched PubMed, Embase, and PsycNET, for articles in English published in peer-reviewed journals from January 1, 1980 to April 23, 2019 using adapted search strategies containing keywords quantitative EEG and Alzheimer. The risk of bias was assessed by applying the QUADAS tool. The systematic review was conducted in line with the PRISMA methodology.ResultsWe identified 10 articles showcasing QEEG features used in diagnosing dementia, EEG slowing phenomena in AD and PDD, coherence changes in AD and VaD, the role of LORETA in dementia, and the controversial QEEG pattern in FTD. Results vary significantly in terms of sociodemographic features of the studied population, neuropsychological assessment, signal acquisition and processing, and methods of analysis.DiscussionThis article provides a comparative synthesis of existing evidence on the role of QEEG in diagnosing dementia, highlighting some specific features for different types of dementia (eg, the slow-wave activity has been remarked in both AD and PDD, but more pronounced in PDD patients, a diminution in anterior and posterior alpha coherence was noticed in AD, and a lower alpha coherence in the left temporal-parietal-occipital regions was observed in VaD).ConclusionQEEG may be a useful investigation for settling the diagnosis of common forms of dementia. Further research of quantitative analyses is warranted, particularly on the association between QEEG, neuropsychological, and imaging features. In conjunction, these methods may provide superior diagnostic accuracy in the diagnosis of dementia., admin,
IntroductionQuantitative electroencephalography (QEEG) has been documented as a helpful tool in the differential diagnosis of Alzheimer’s disease (AD) with common forms of dementia. The main objective of the study was to assess the role of QEEG in AD differential diagnosis with other forms of dementia: Lewy body dementia (LBD), Parkinson’s disease dementia (PDD), frontotemporal dementia (FTD), and vascular dementia (VaD).MethodsWe searched PubMed, Embase, and PsycNET, for articles in English published in peer-reviewed journals from January 1, 1980 to April 23, 2019 using adapted search strategies containing keywords quantitative EEG and Alzheimer. The risk of bias was assessed by applying the QUADAS tool. The systematic review was conducted in line with the PRISMA methodology.ResultsWe identified 10 articles showcasing QEEG features used in diagnosing dementia, EEG slowing phenomena in AD and PDD, coherence changes in AD and VaD, the role of LORETA in dementia, and the controversial QEEG pattern in FTD. Results vary significantly in terms of sociodemographic features of the studied population, neuropsychological assessment, signal acquisition and processing, and methods of analysis.DiscussionThis article provides a comparative synthesis of existing evidence on the role of QEEG in diagnosing dementia, highlighting some specific features for different types of dementia (eg, the slow-wave activity has been remarked in both AD and PDD, but more pronounced in PDD patients, a diminution in anterior and posterior alpha coherence was noticed in AD, and a lower alpha coherence in the left temporal-parietal-occipital regions was observed in VaD).ConclusionQEEG may be a useful investigation for settling the diagnosis of common forms of dementia. Further research of quantitative analyses is warranted, particularly on the association between QEEG, neuropsychological, and imaging features. In conjunction, these methods may provide superior diagnostic accuracy in the diagnosis of dementia., admin,
Pavlovian eyeblink conditioning is severely impaired in tottering mice
Pavlovian eyeblink conditioning is severely impaired in tottering mice, Journal of Neurophysiology, Volume 125, Issue 2, Page 398-407, February 2021. , Journal of Neurophysiology, Volume 125, Issue 2, Page 398-407, February 2021.
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Sensory Filtering and Sensory Memory in Breast Cancer Survivors
Sensory Filtering and Sensory Memory in Breast Cancer Survivors, Clinical EEG and Neuroscience, Ahead of Print. Survivors of breast and other cancers often report protracted difficulty in performing tasks involving concentration and memory, even years after the completion of treatment., Clinical EEG and Neuroscience, Ahead of Print.
Survivors of breast and other cancers often report protracted difficulty in performing tasks involving concentration and memory, even years after the completion of treatment. The current study investigated whether cancer and treatment history is associated with deficits in sensory filtering (gating out) and sensory memory (gating in), early processes in stimulus processing that may contribute to difficulties in later remembering. A group of breast cancer survivors and age-matched healthy control participants (mean age 54 years) underwent testing with paired-click and oddball tasks while electroencephalographic (EEG) signals were recorded. The survivors showed relatively poor inhibition of redundant sensory stimulation (P50 suppression). Dipole source analysis localized the survivors’ impairment to the hippocampus, with preservation of function in gating mechanisms of the frontal lobe and auditory cortex. Survivors also showed disruption to sensory memory processes needed to register novel information in an otherwise uniform auditory environment (mismatch negativity). The findings suggest that survivors experience deficits in early, automatic mechanisms of sensory gating, which may trigger a cascade of later perceived attentional and memory deficits. If our account is accurate, ideal therapies might aim to restore early inhibitory processes, such as those gauged by P50 suppression., admin,
Survivors of breast and other cancers often report protracted difficulty in performing tasks involving concentration and memory, even years after the completion of treatment. The current study investigated whether cancer and treatment history is associated with deficits in sensory filtering (gating out) and sensory memory (gating in), early processes in stimulus processing that may contribute to difficulties in later remembering. A group of breast cancer survivors and age-matched healthy control participants (mean age 54 years) underwent testing with paired-click and oddball tasks while electroencephalographic (EEG) signals were recorded. The survivors showed relatively poor inhibition of redundant sensory stimulation (P50 suppression). Dipole source analysis localized the survivors’ impairment to the hippocampus, with preservation of function in gating mechanisms of the frontal lobe and auditory cortex. Survivors also showed disruption to sensory memory processes needed to register novel information in an otherwise uniform auditory environment (mismatch negativity). The findings suggest that survivors experience deficits in early, automatic mechanisms of sensory gating, which may trigger a cascade of later perceived attentional and memory deficits. If our account is accurate, ideal therapies might aim to restore early inhibitory processes, such as those gauged by P50 suppression., admin,
Simultaneous Electroencephalographic and Electocorticographic Recordings of Lateralized Periodic Discharges...
Simultaneous Electroencephalographic and Electocorticographic Recordings of Lateralized Periodic Discharges..., Clinical EEG and Neuroscience, Ahead of Print. ObjectiveLateralized periodic discharges (LPDs), which constitute an abnormal electroencephalographic (EEG) pattern, are most often observed in critically ill patients with acute pathological conditions, and are less frequently observed in chronic conditions such as focal epilepsies, including temporal lobe epilepsy (TLE)., Clinical EEG and Neuroscience, Ahead of Print.
ObjectiveLateralized periodic discharges (LPDs), which constitute an abnormal electroencephalographic (EEG) pattern, are most often observed in critically ill patients with acute pathological conditions, and are less frequently observed in chronic conditions such as focal epilepsies, including temporal lobe epilepsy (TLE). Here we aim to explore the pathophysiological mechanism of LPD in TLE.MethodsWe retrospectively selected 3 patients with drug-resistant TLE who simultaneously underwent EEG and electrocorticography (ECoG) and demonstrated LPDs. We analyzed the correlation between the EEG and ECoG findings.ResultsIn patients 1 and 2, LPDs were recorded in the temporal region of the scalp during the interictal periods, when repeated spikes followed by slow waves (spike-and-wave complexes; SWs) and periodic discharges (PDs) with amplitudes of >600 to 800 µV appeared in the lateral temporal lobe over a cortical area of >10 cm2. In patient 3, when the ictal discharges persisted and were confined to the medial temporal lobe, repeated SWs were provoked on the lateral temporal lobe. When repeated SWs with amplitudes of >800 µV appeared in an area of the lateral temporal lobe of >10 cm2, the corresponding EEG discharges appeared on the temporal scalp.ConclusionsLPDs in patients with TLE originate from repeated SWs and PDs of the lateral temporal lobe, which might represent a highly irritable state of the lateral temporal cortex during both interictal and ictal periods., admin,
ObjectiveLateralized periodic discharges (LPDs), which constitute an abnormal electroencephalographic (EEG) pattern, are most often observed in critically ill patients with acute pathological conditions, and are less frequently observed in chronic conditions such as focal epilepsies, including temporal lobe epilepsy (TLE). Here we aim to explore the pathophysiological mechanism of LPD in TLE.MethodsWe retrospectively selected 3 patients with drug-resistant TLE who simultaneously underwent EEG and electrocorticography (ECoG) and demonstrated LPDs. We analyzed the correlation between the EEG and ECoG findings.ResultsIn patients 1 and 2, LPDs were recorded in the temporal region of the scalp during the interictal periods, when repeated spikes followed by slow waves (spike-and-wave complexes; SWs) and periodic discharges (PDs) with amplitudes of >600 to 800 µV appeared in the lateral temporal lobe over a cortical area of >10 cm2. In patient 3, when the ictal discharges persisted and were confined to the medial temporal lobe, repeated SWs were provoked on the lateral temporal lobe. When repeated SWs with amplitudes of >800 µV appeared in an area of the lateral temporal lobe of >10 cm2, the corresponding EEG discharges appeared on the temporal scalp.ConclusionsLPDs in patients with TLE originate from repeated SWs and PDs of the lateral temporal lobe, which might represent a highly irritable state of the lateral temporal cortex during both interictal and ictal periods., admin,
Using asymmetry to your advantage: learning to acquire and accept external assistance during prolonged...
Using asymmetry to your advantage: learning to acquire and accept external assistance during prolonged..., Journal of Neurophysiology, Volume 125, Issue 2, Page 344-357, February 2021. , Journal of Neurophysiology, Volume 125, Issue 2, Page 344-357, February 2021.
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Quantitative EEG Analysis in Angelman Syndrome: Candidate Method for Assessing Therapeutics
Quantitative EEG Analysis in Angelman Syndrome: Candidate Method for Assessing Therapeutics, Clinical EEG and Neuroscience, Ahead of Print. The goal of these studies was to use quantitative (q)EEG techniques on data from children with Angelman syndrome (AS) using spectral power analysis, and to evaluate this as a potential biomarker and quantitative method to evaluate therapeutics., Clinical EEG and Neuroscience, Ahead of Print.
The goal of these studies was to use quantitative (q)EEG techniques on data from children with Angelman syndrome (AS) using spectral power analysis, and to evaluate this as a potential biomarker and quantitative method to evaluate therapeutics. Although characteristic patterns are evident in visual inspection, using qEEG techniques has the potential to provide quantitative evidence of treatment efficacy. We first assessed spectral power from baseline EEG recordings collected from children with AS compared to age-matched neurotypical controls, which corroborated the previously reported finding of increased total power driven by elevated delta power in children with AS. We then retrospectively analyzed data collected during a clinical trial evaluating the safety and tolerability of minocycline (3 mg/kg/d) to compare pretreatment recordings from children with AS (4-12 years of age) to EEG activity at the end of treatment and following washout for EEG spectral power and epileptiform events. At baseline and during minocycline treatment, the AS subjects demonstrated increased delta power; however, following washout from minocycline treatment the AS subjects had significantly reduced EEG spectral power and epileptiform activity. Our findings support the use of qEEG analysis in evaluating AS and suggest that this technique may be useful to evaluate therapeutic efficacy in AS. Normalizing EEG power in AS therefore may become an important metric in screening therapeutics to gauge overall efficacy. As therapeutics transition from preclinical to clinical studies, it is vital to establish outcome measures that can quantitatively evaluate putative treatments for AS and neurological disorders with distinctive EEG patterns., admin,
The goal of these studies was to use quantitative (q)EEG techniques on data from children with Angelman syndrome (AS) using spectral power analysis, and to evaluate this as a potential biomarker and quantitative method to evaluate therapeutics. Although characteristic patterns are evident in visual inspection, using qEEG techniques has the potential to provide quantitative evidence of treatment efficacy. We first assessed spectral power from baseline EEG recordings collected from children with AS compared to age-matched neurotypical controls, which corroborated the previously reported finding of increased total power driven by elevated delta power in children with AS. We then retrospectively analyzed data collected during a clinical trial evaluating the safety and tolerability of minocycline (3 mg/kg/d) to compare pretreatment recordings from children with AS (4-12 years of age) to EEG activity at the end of treatment and following washout for EEG spectral power and epileptiform events. At baseline and during minocycline treatment, the AS subjects demonstrated increased delta power; however, following washout from minocycline treatment the AS subjects had significantly reduced EEG spectral power and epileptiform activity. Our findings support the use of qEEG analysis in evaluating AS and suggest that this technique may be useful to evaluate therapeutic efficacy in AS. Normalizing EEG power in AS therefore may become an important metric in screening therapeutics to gauge overall efficacy. As therapeutics transition from preclinical to clinical studies, it is vital to establish outcome measures that can quantitatively evaluate putative treatments for AS and neurological disorders with distinctive EEG patterns., admin,
Plastic changes in primate motor cortex following paired peripheral nerve stimulation
Plastic changes in primate motor cortex following paired peripheral nerve stimulation, Journal of Neurophysiology, Volume 125, Issue 2, Page 458-475, February 2021. , Journal of Neurophysiology, Volume 125, Issue 2, Page 458-475, February 2021.
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The Effects of Theta EEG Neurofeedback on the Consolidation of Spatial Memory
The Effects of Theta EEG Neurofeedback on the Consolidation of Spatial Memory, Clinical EEG and Neuroscience, Ahead of Print. How can the stability of a recently acquired memory be improved? Recent findings regarding the importance of theta frequency EEG activity in the hippocampus suggest that entraining neural activity in that frequency band might increase post-encoding waking replay, reinforcing learning-related plasticity., Clinical EEG and Neuroscience, Ahead of Print.
How can the stability of a recently acquired memory be improved? Recent findings regarding the importance of theta frequency EEG activity in the hippocampus suggest that entraining neural activity in that frequency band might increase post-encoding waking replay, reinforcing learning-related plasticity. Our previous studies revealed that upregulating postlearning theta power using EEG neurofeedback (NFB) significantly benefitted procedural and episodic memory performance (both immediate and delayed), and may provide optimal conditions for stabilization of new memories. We have now explored whether memory benefits of theta NFB generalize to delayed spatial memory, an additional hippocampus-dependent process. Participants learned to associate object images with locations on a computer screen. NFB was used to enable participants to selectively increase scalp EEG theta power for 30 minutes. Visuo-spatial memory was tested one week later, with the theta NFB participants compared with 2 control groups (beta-augmentation NFB as an active control group, and an additional passive control group that did not engage in NFB). Theta upregulation was found to improve visuo-spatial memory, as reflected in reduced error distances in location marking and faster reaction time for correct answers by the theta group. This supports the contention that theta upregulation immediately after learning strengthens early consolidation of visuo-spatial memory. This intervention could potentially benefit various memory-challenged populations, as well as healthy individuals., admin,
How can the stability of a recently acquired memory be improved? Recent findings regarding the importance of theta frequency EEG activity in the hippocampus suggest that entraining neural activity in that frequency band might increase post-encoding waking replay, reinforcing learning-related plasticity. Our previous studies revealed that upregulating postlearning theta power using EEG neurofeedback (NFB) significantly benefitted procedural and episodic memory performance (both immediate and delayed), and may provide optimal conditions for stabilization of new memories. We have now explored whether memory benefits of theta NFB generalize to delayed spatial memory, an additional hippocampus-dependent process. Participants learned to associate object images with locations on a computer screen. NFB was used to enable participants to selectively increase scalp EEG theta power for 30 minutes. Visuo-spatial memory was tested one week later, with the theta NFB participants compared with 2 control groups (beta-augmentation NFB as an active control group, and an additional passive control group that did not engage in NFB). Theta upregulation was found to improve visuo-spatial memory, as reflected in reduced error distances in location marking and faster reaction time for correct answers by the theta group. This supports the contention that theta upregulation immediately after learning strengthens early consolidation of visuo-spatial memory. This intervention could potentially benefit various memory-challenged populations, as well as healthy individuals., admin,
Properties of visually guided saccadic behavior and bottom-up attention in marmoset, macaque, and human
Properties of visually guided saccadic behavior and bottom-up attention in marmoset, macaque, and human, Journal of Neurophysiology, Volume 125, Issue 2, Page 437-457, February 2021. , Journal of Neurophysiology, Volume 125, Issue 2, Page 437-457, February 2021.
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Use of Unconventional Therapies in Super-refractory Status Epilepticus: A Case Report and Literature Review
Use of Unconventional Therapies in Super-refractory Status Epilepticus: A Case Report and Literature Review, Clinical EEG and Neuroscience, Ahead of Print. Super-refractory status epilepticus (SRSE) is a life-threatening condition characterized by the persistence or recurrence of seizures despite the use of first- and second-line antiepileptic drugs and the continuous infusion of anesthetics for more than 24 hours., Clinical EEG and Neuroscience, Ahead of Print.
Super-refractory status epilepticus (SRSE) is a life-threatening condition characterized by the persistence or recurrence of seizures despite the use of first- and second-line antiepileptic drugs and the continuous infusion of anesthetics for more than 24 hours. This has always been a challenge for the physician, given the high mortality and morbidity related to this condition. Unfortunately, there are currently no definitive data to guide the therapy, since most of the therapeutic approaches regarding SRSE come from anecdotal evidence. Here, we present a case report of long-persisting new-onset SRSE treated with unconventional therapies recently reported to be successful such as ketamine, ketogenic diet, and tocilizumab, that could have played an important role in the management of this patient. A review of the literature regarding those is also included. SRSE has been reported to have long hospital length of stay, with a small percentage of patients returning to baseline functional status. Moreover, recent evidence showed that functional and cognitive outcome could depend on seizure duration, so prolonged duration of epileptic activity with abnormalities on the magnetic resonance imaging (MRI) could be seen as a reason to discontinue treatment. However, despite many weeks of seizures and a noncomforting MRI, our patient was discharged with a good functional status., admin,
Super-refractory status epilepticus (SRSE) is a life-threatening condition characterized by the persistence or recurrence of seizures despite the use of first- and second-line antiepileptic drugs and the continuous infusion of anesthetics for more than 24 hours. This has always been a challenge for the physician, given the high mortality and morbidity related to this condition. Unfortunately, there are currently no definitive data to guide the therapy, since most of the therapeutic approaches regarding SRSE come from anecdotal evidence. Here, we present a case report of long-persisting new-onset SRSE treated with unconventional therapies recently reported to be successful such as ketamine, ketogenic diet, and tocilizumab, that could have played an important role in the management of this patient. A review of the literature regarding those is also included. SRSE has been reported to have long hospital length of stay, with a small percentage of patients returning to baseline functional status. Moreover, recent evidence showed that functional and cognitive outcome could depend on seizure duration, so prolonged duration of epileptic activity with abnormalities on the magnetic resonance imaging (MRI) could be seen as a reason to discontinue treatment. However, despite many weeks of seizures and a noncomforting MRI, our patient was discharged with a good functional status., admin,
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