Rules for a routine electroencephalogram recording

2021 ◽  
pp. 34-38
Author(s):  
M. V. Sinkin ◽  
E. P. Bogdanova ◽  
O. D. Elshina ◽  
A. A. Troitskiy
Keyword(s):  
Critical Care ◽  
Functional Assessment ◽  
Common Type ◽  
Critical Care Medicine ◽  
Bioelectrical Activity ◽  
Epileptogenic Zone ◽  
Primary Method ◽  
Paper Briefly ◽  
Presurgical Evaluation ◽  
The Brain

Electroencephalography (EEG) is the primary method for functional assessment of the brain bioelectrical activity. It is the most effective for epilepsy diagnosing, and also used for localization of the epileptogenic zone in presurgical evaluation for pharmaco-resistant epilepsy and in critical care medicine. In practice, the most common type is a 'routine' EEG, the informative value of which depends largely on the accuracy of its performance. The paper briefly outlines the rules for performing a routine EEG and lists the most common mistakes that can affect its interpretation.

scholarly journals Presurgical Evaluation of Epilepsy Using Resting-State MEG Functional Connectivity

2021 ◽  
Vol 15 ◽  
Author(s):  
Na Xu ◽  
Wei Shan ◽  
Jing Qi ◽  
Jianping Wu ◽  
Qun Wang
Keyword(s):  
Functional Connectivity ◽  
Resting State ◽  
Preoperative Evaluation ◽  
Brain Regions ◽  
Electrophysiological Recording ◽  
Epileptogenic Zone ◽  
Resting State Functional Connectivity ◽  
Presurgical Evaluation ◽  
Resting State Connectivity ◽  
The Brain

Epilepsy is caused by abnormal electrical discharges (clinically identified by electrophysiological recording) in a specific part of the brain [originating in only one part of the brain, namely, the epileptogenic zone (EZ)]. Epilepsy is now defined as an archetypical hyperexcited neural network disorder. It can be investigated through the network analysis of interictal discharges, ictal discharges, and resting-state functional connectivity. Currently, there is an increasing interest in embedding resting-state connectivity analysis into the preoperative evaluation of epilepsy. Among the various neuroimaging technologies employed to achieve brain functional networks, magnetoencephalography (MEG) with the excellent temporal resolution is an ideal tool for estimating the resting-state connectivity between brain regions, which can reveal network abnormalities in epilepsy. What value does MEG resting-state functional connectivity offer for epileptic presurgical evaluation? Regarding this topic, this paper introduced the origin of MEG and the workflow of constructing source–space functional connectivity based on MEG signals. Resting-state functional connectivity abnormalities correlate with epileptogenic networks, which are defined by the brain regions involved in the production and propagation of epileptic activities. This paper reviewed the evidence of altered epileptic connectivity based on low- or high-frequency oscillations (HFOs) and the evidence of the advantage of using simultaneous MEG and intracranial electroencephalography (iEEG) recordings. More importantly, this review highlighted that MEG-based resting-state functional connectivity has the potential to predict postsurgical outcomes. In conclusion, resting-state MEG functional connectivity has made a substantial progress toward serving as a candidate biomarker included in epileptic presurgical evaluations.

Neurophysiological phenotypes of pharmacoresistant temporal lobe epilepsy

2021 ◽  
pp. 9-12
Author(s):  
M. V. Aleksandrov ◽  
Y. V. Marchenko
Keyword(s):  
Surgical Treatment ◽  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Epileptic Focus ◽  
Bioelectrical Activity ◽  
Epileptogenic Zone ◽  
Invasive Monitoring ◽  
Ictal Activity ◽  
The Brain

Patients with a drug-resistant form of epilepsy can be treated by neurosurgery through the destruction or separation of the epileptic focus. If the results of clinical, neuro-imaging and neurophysiological methods are discordant, then the localization of the epileptogenic zone is performed based on the results of long-term invasive monitoring of the bioelectrical activity of the cortex and deep structures of the brain. The aim of this work was the retrospective analysis of the results of invasive monitoring of the bioelectrical activity of the brain to clarify the mechanisms of the formation of patterns of interictal and ictal activity in structural epilepsy. The study included 35 patients (18 men, 17 women) with drug-resistant temporal lobe epilepsy, who were treated at the Polenov Neurosurgical Institute. The examination included video-EEG monitoring, long-term invasive monitoring of bioelectrical activity of the cortex, and deep brain structures. The patients were divided into two groups according to the type of surgical treatment: 1) micro-surgical resection of the epileptic focus, including the zone of structural changes (24 patients); 2) stereotactic destruction of the amygdala-hippocampal complex (6 patients). The follow-up of the outcomes of the surgical treatment took place over 2-3 years. Depending on the results of the surgical treatment, the patients were divided into two groups: 1) patients with a favorable outcome (Engel 1–2) — 15 patients and 2) patients with no positive dynamics and a relatively poor outcome (Engel 3–4) — 15 patients. The results obtained showed that the patterns of interictal and ictal activity in their totality determine the neurophysiology, i.e the phenotype of temporal lobe epilepsy, reflecting the interference of pathogenetic and sanogenetic mechanisms. The localization of the epileptogenic zone should be based on the cumulative assessment of interictal and ictal activity. The presence of more than one focus of interictal activity, the secondary spread of epileptiform activity from the primary focus, are prognostically unfavorable factors.

Fact file 1: Critical care and emergency medicine

2017 ◽  
Author(s):  
Daisy Fancourt
Keyword(s):  
Emergency Medicine ◽  
Critical Care ◽  
Sports Medicine ◽  
Orthopaedic Surgery ◽  
Extreme Environment ◽  
Disaster Medicine ◽  
Medical Attention ◽  
Life Threatening ◽  
Medical Disciplines ◽  
The Brain

Emergency medicine involves the care of patients who require immediate medical attention. The specialty encompasses a broad range of medical disciplines, including anaesthesia, cardiology (a field related to the heart), neurology (a field related to the brain), plastic surgery, orthopaedic surgery (surgery relating to the bones or muscles), and cardiothoracic surgery (surgery relating to the heart, chest, or lungs). There are also a number of subspecialties including extreme environment medicine, disaster medicine and sports medicine. Related to emergency medicine is the specialty of critical care medicine, which is concerned with the care of patients with life-threatening conditions often treated in intensive care settings....

scholarly journals The pathophysiology of “happy” hypoglycemia

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Thomas Loeb ◽  
Anna Ozguler ◽  
Geraldine Baer ◽  
Michel Baer
Keyword(s):  
Critical Care ◽  
Hemorrhagic Shock ◽  
Lactate Production ◽  
Severe Hypoglycemia ◽  
Altered Mental Status ◽  
Case Presentation ◽  
Energy Substrate ◽  
Tissue Hypoperfusion ◽  
The Brain ◽  
Critical Care Patients

Abstract Background Hypoglycemia usually includes various neurological symptoms, which are the consequence of neuroglycopenia. When it is severe, it is associated with altered mental status, even coma. Case presentation We report the case of a patient with severe hypoglycemia, completely asymptomatic, due to the increase of lactate production in response to tissue hypoperfusion following a hemorrhagic shock. This illustrates that lactate can substitute glucose as an energy substrate for the brain. It is also a reminder that this metabolite, despite its bad reputation maintained by its role as a marker of severity in critical care patients, has a fundamental role in our metabolism. Conclusions Following the example of the “happy hypoxemia” recently reported in the literature describing asymptomatic hypoxemia in COVID-19 patients, we describe a case of “happy hypoglycemia.”

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