Components of Mid-clerkship Feedback in a Neurology Clerkship and their Impact on Subsequent Student Performance.

Feedback during clinical rotations can be valuable in improving medical student education, but it is unclear what effect such feedback has on subsequent clinical performance and also which feedback topics are the most important in student growth and education. We compared medical student clinical performance before and after mid-clerkship feedback in a Neurology clerkship, with evaluators at the mid-clerkship and at the end blinded to the others' comments. We found that the most important areas holding back student clinical performance were communication, interpersonal interactions, and work ethic rather than textbook knowledge, or the ability to take a history, and do a physical and neurologic examination.

Minimum Technical Requirements for Performing Ambulatory EEG.

Ambulatory EEG (AEEG) devices offer portable, multichannel, digital EEG recording with or without video in the patient's natural environment. The technology applied for AEEG recording is like the technology for routine EEG and inpatient long-term video-EEG monitoring but designed to be compact and wearable. Computer-based AEEG technology is well-suited to digital recording, signal processing, and visual display.

Nonconvulsive seizures and nonconvulsive status epilepticus in the neuro ICU should or should not be treated aggressively: A debate.

This article presents a "debate" about the appropriate level of aggressiveness of treatment for nonconvulsive status epilepticus (NCSE), held at the International Congress of Clinical Neurophysiology in Washington D.C. on 4 May 2018.

Treatment of Refractory and Super-refractory Status Epilepticus.

Refractory and super-refractory status epilepticus (SE) are serious illnesses with a high risk of morbidity and even fatality. In the setting of refractory generalized convulsive SE (GCSE), there is ample justification to use continuous infusions of highly sedating medications-usually midazolam, pentobarbital, or propofol. Each of these medications has advantages and disadvantages, and the particulars of their use remain controversial.

Lateralized Periodic Discharges: A Literature Review.

The purpose of this article is to provide a comprehensive review of the literature about a particular EEG pattern, lateralized periodic discharges (LPDs), or periodic lateralized epileptiform discharges (PLEDs). The review will discuss the history and terminology of LPDs and provide a detailed summary of the etiologies, pathophysiology, clinical symptoms, and imaging studies related to LPDs. Current controversies about the association of LPDs with seizures and their management will be reviewed.

Therapeutic coma for status epilepticus: Differing practices in a prospective multicenter study.

Objective: Our aim was to analyze and compare the use of therapeutic coma (TC) for refractory status epilepticus (SE) across different centers and its effect on outcome.

Methods: Clinical data for all consecutive adults (>16 years) with SE of all etiologies (except postanoxic) admitted to 4 tertiary care centers belonging to Harvard Affiliated Hospitals (HAH) and the Centre Hospitalier Universitaire Vaudois (CHUV) were prospectively collected and analyzed for TC details, mortality, and duration of hospitalization.

Results: Two hundred thirty-six SE episodes in the CHUV and 126 in the HAH were identified.

American Clinical Neurophysiology Society: EEG Guidelines Introduction.

This revision to the EEG Guidelines is an update incorporating current EEG technology and practice. "Standards of practice in clinical electroencephalography" (previously Guideline 4) has been removed. It is currently undergoing revision through collaboration among multiple medical societies and will become part of "Qualifications and Responsibilities of Personnel Performing and Interpreting Clinical Neurophysiology Procedures.

American Clinical Neurophysiology Society Guideline 5: Minimum Technical Standards for Pediatric Electroencephalography.

This revision to the EEG Guidelines is an update incorporating the current electroencephalography technology and practice. It was previously published as Guideline 2. Similar to the prior guideline, it delineates the aspects of Guideline 1 that should be modified for neonates and young children.

American Clinical Neurophysiology Society Guideline 7: Guidelines for EEG Reporting.

This EEG Guideline incorporates the practice of structuring a report of results obtained during routine adult electroencephalography. It is intended to reflect one of the current practices in reporting an EEG and serves as a revision of the previous guideline entitled "Writing an EEG Report." The goal of this guideline is not only to convey clinically relevant information, but also to improve interrater reliability for clinical and research use by standardizing the format of EEG reports.

American Clinical Neurophysiology Society Guideline 6: Minimum Technical Standards for EEG Recording in Suspected Cerebral Death.

This revision to the EEG Guidelines is an update incorporating current EEG technology and practice. The role of the EEG in making the determination of brain death is discussed as are suggested technical criteria for making the diagnosis of electrocerebral inactivity.

Is Favorable Outcome Possible After Prolonged Refractory Status Epilepticus?

When status epilepticus (SE) remains refractory to appropriate therapy, it is associated with high mortality and with substantial morbidity in survivors. Many outcome predictors such as age, seizure type, level of consciousness before treatment, and mostly, etiology, are well-established. A longer duration of SE is often associated with worse outcome, but duration may lose its prognostic value after several hours.

American Clinical Neurophysiology Society Guideline 5: Minimum Technical Standards for Pediatric Electroencephalography.

This revision to the EEG Guidelines is an update incorporating the current electroencephalography technology and practice. It was previously published as Guideline 2. Similar to the prior guideline, it delineates the aspects of Guideline 1 that should be modified for neonates and young children.

American Clinical Neurophysiology Society Guideline 4: Recording Clinical EEG on Digital Media.

Digital EEG recording systems are now widely available and relatively inexpensive. They offer multiple advantages over previous analog/paper systems, such as higher fidelity recording, signal postprocessing, automated detection, and efficient data storage. This document provides guidance for the creation of digital EEG recordings including (1) documentation of patient information, (2) notation of information during the recording, (3) digital signal acquisition parameters during the recording, (4) storage of digital information, and (5) display of digital EEG signals.

American Clinical Neurophysiology Society Guideline 7: Guidelines for EEG Reporting.

This EEG Guideline incorporates the practice of structuring a report of results obtained during routine adult electroencephalography. It is intended to reflect one of the current practices in reporting an EEG and serves as a revision of the previous guideline entitled "Writing an EEG Report." The goal of this guideline is not only to convey clinically relevant information, but also to improve interrater reliability for clinical and research use by standardizing the format of EEG reports.

American Clinical Neurophysiology Society Guideline 6: Minimum Technical Standards for EEG Recording in Suspected Cerebral Death.

This revision to the EEG Guidelines is an update incorporating current EEG technology and practice. The role of the EEG in making the determination of brain death is discussed as are suggested technical criteria for making the diagnosis of electrocerebral inactivity.

American Clinical Neurophysiology Society: EEG Guidelines Introduction.

This revision to the EEG Guidelines is an update incorporating current EEG technology and practice. "Standards of practice in clinical electroencephalography" (previously Guideline 4) has been removed. It is currently undergoing revision through collaboration among multiple medical societies and will become part of "Qualifications and Responsibilities of Personnel Performing and Interpreting Clinical Neurophysiology Procedures.

Practice variability and efficacy of clonazepam, lorazepam, and midazolam in status epilepticus: A multicenter comparison.

Objective: Benzodiazepines (BZD) are recommended as first-line treatment for status epilepticus (SE), with lorazepam (LZP) and midazolam (MDZ) being the most widely used drugs and part of current treatment guidelines. Clonazepam (CLZ) is also utilized in many countries; however, there is no systematic comparison of these agents for treatment of SE to date.

Methods: We identified all patients treated with CLZ, LZP, or MDZ as a first-line agent from a prospectively collected observational cohort of adult patients treated for SE in four tertiary care centers.

American Clinical Neurophysiology Society Guideline 4: Recording Clinical EEG on Digital Media.

Digital EEG recording systems are now widely available and relatively inexpensive. They offer multiple advantages over previous analog/paper systems, such as higher fidelity recording, signal postprocessing, automated detection, and efficient data storage. This document provides guidance for the creation of digital EEG recordings including (1) documentation of patient information, (2) notation of information during the recording, (3) digital signal acquisition parameters during the recording, (4) storage of digital information, and (5) display of digital EEG signals.