The utility of Multicentre Epilepsy Lesion Detection (MELD) algorithm in identifying epileptic activity and predicting seizure freedom in MRI lesion-negative paediatric patients.

Aim: Paediatric patients with drug-resistant focal epilepsy (DRFE) who have no clear focal lesion identified on conventional structural magnetic resonance imaging (MRI) are a particularly challenging cohort to treat and form an increasing part of epilepsy surgery programs. A recently developed deep-learning-based MRI lesion detection algorithm, the Multicentre Lesion Detection (MELD) algorithm, has been shown to aid detection of focal cortical dysplasia (FCD). We applied this algorithm retrospectively to a cohort of MRI-negative children with refractory focal epilepsy who underwent stereoelectroencephalography (SEEG) to determine its accuracy in identifying unseen epileptic lesions, seizure onset zones and clinical outcomes.

Amplitude-reduction alert criteria and intervention during complex paediatric cervical spine surgery.

Objective: To determine the utility of widely used intraoperative neuromonitoring (IONM) alert criteria and intervention for predicting postoperative outcome following paediatric spinal surgery.

Methods: Retrospective analysis of somatosensory evoked potentials (SSEP) and motor evoked potentials (MEP) in consecutive cervical spine fixations. An intervention protocol followed amplitude-reductions in SSEPs (≥50 %) and/or MEPs (≥80 %).

Functional hemispherotomy for epilepsy in the very young.

Objective: Epilepsy is one of the most common neurological disorders in children. Among very young children, one-third are resistant to medical treatment, and lack of effective treatment may result in adverse outcomes. Although functional hemispherotomy is an established treatment for epilepsy, its outcome in the very young child has not been widely reported.

Pediatric stereo-electroencephalography: effects of robot assistance and other variables on seizure outcome and complications.

Objective: The safety of stereo-electroencephalography (SEEG) has been investigated; however, most studies have not differentiated pediatric and adult populations, which have different anatomy and physiology. The purpose of this study was to assess SEEG safety in the pediatric setting, focusing on surgical complications and the identification of patient and surgical risk factors, if any. The authors also aimed to determine whether robot assistance in SEEG was associated with a change in practice, surgical parameters, and clinical outcomes.

Peripheral nerve electrophysiology studies in relation to fatigue in patients with chronic inflammatory demyelinating polyneuropathy.

Objective: To explore the relationship between fatigue, standard electrophysiological parameters and number and size of functioning motor units in patients with chronic inflammatory demyelinating polyneuropathy (CIDP).

Methods: Experienced fatigue was assessed using the linearly-weighted, modified Rasch-built fatigue severity scale (R-FSS) and the multidimensional Checklist of Individual Strength (CIS). Averaged electrophysiology values were calculated from multiple nerves.

Clinical correlates of fatigue in chronic inflammatory demyelinating polyneuropathy.

Introduction: Fatigue is a recognized manifestation of immune-mediated neuropathies, but its causes and implications are unclear. In this study, we explored the correlates of fatigue among a number of clinical parameters in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) to better understand potential contributing factors and resulting consequences.

Methods: Twenty-six clinically stable patients with CIDP underwent assessments of motor and sensory function, disability, quality of life, and depression and anxiety.

Prevalence and clinical correlates of non-convulsive status epilepticus in elderly patients with acute confusional state: A systematic literature review.

Non-convulsive status epilepticus (NCSE) is a potentially treatable condition that poses considerable diagnostic challenges. NCSE is thought to be more common in the elderly than in the general population, however additional diagnostic challenges complicate its recognition in older patients, because of the wide differential diagnosis with common underlying causes of acute confusional state in this age group. We set out to review the existing evidence on the clinical correlates of NCSE in the elderly population.

The role of electroencephalography in the early diagnosis of non-convulsive status epilepticus in elderly patients with acute confusional state: Two possible strategies?

Non-convulsive status epilepticus (NCSE) can pose considerable diagnostic challenges, especially in the elderly, because of the wide differential diagnosis with common underlying causes of acute confusional state in this age group. We reviewed the proposed electroencephalography (EEG) strategies to improve the diagnostic yield of non-convulsive status epilepticus in the elderly population. Specifically, a debated topic of clinical relevance is the exact role of the EEG in the early diagnosis of NCSE in the elderly.

Motor unit number index (MUNIX) in chronic inflammatory demyelinating polyneuropathy: A potential role in monitoring response to intravenous immunoglobulins.

Objective: To compare motor unit number index (MUNIX) values in patients with chronic inflammatory demyelinating polyneuropathy (CIDP) and healthy controls, to assess correlations between MUNIX and clinical assessments used in CIDP and to assess short-term changes in MUNIX in CIDP following intravenous immunoglobulins (IVIg).

Methods: MUNIX sum scores were calculated from three muscles in patients and healthy controls. CIDP patients also underwent a series of clinical assessments and completed the Overall Neuropathy Limitations Scale (ONLS) and the Rasch-built Overall-Disability Scale (R-ODS).

Impact of video-ambulatory electroencephalography on the medical management of epilepsy.

Video-ambulatory electroencephalography (video-AEEG) is increasingly being used in secondary care centres for the diagnostic work-up of new cases with suspected epilepsy and for the review of known cases with active seizures despite medical treatment. We reviewed how the outcome of video-AEEG influenced the medical management of patients who underwent this investigation at a neurophysiology department within a secondary care centre. Out of a total of 171 consecutive video-AEEG studies performed over a period of two years, 111 could be included in our retrospective analysis, based on availability and completeness of relevant clinical information pre- and post-investigation.

Posterior interosseous neuropathy: the diagnostic benefits of a multimodal approach to investigation.

Posterior interosseous neuropathy should be considered in patients presenting with finger and wrist drop and no sensory deficit. Clinical and electrophysiological assessments are key to a diagnosis. MRI may disclose etiological information not available to clinical or neurophysiological assessment, and should be thought as a complementary diagnostic tool.

Video-ambulatory EEG in a secondary care center: A retrospective evaluation of utility in the diagnosis of epileptic and nonepileptic seizures.

The development and optimization of protocols using simultaneous video recording alongside long-term electroencephalography (EEG), such as ambulatory EEG (AEEG), expanded the range of available techniques for the investigation of paroxysmal clinical events. In particular, video-AEEG has received increasing attention over the last few years because of its potential to further improve diagnostic utility in the differential diagnosis between epileptic and nonepileptic seizures. We retrospectively evaluated 88 video-AEEG studies in order to assess the diagnostic utility of video-AEEG in 87 patients consecutively referred to a neurophysiology department.

The role of outpatient ambulatory electroencephalography in the diagnosis and management of adults with epilepsy or nonepileptic attack disorder: A systematic literature review.

Electroencephalography (EEG) is an established diagnostic tool with important implications for the clinical management of patients with epilepsy or nonepileptic attack disorder. Different types of long-term EEG recording strategies have been developed over the last decades, including the widespread use of ambulatory electroencephalography (AEEG), which holds great potential in terms of both clinical usefulness and cost-effectiveness. In this paper, we present the results of a systematic review of the scientific literature on the use of AEEG in the diagnosis of epilepsy and nonepileptic attacks in adult patients.