An audit of continuous EEG monitoring in the neurological-neurosurgical intensive care unit.

Purpose: The use of long-term continuous EEG (cEEG) monitoring in neurological-neurosurgical intensive care units (NSICU) has witnessed an exponential increase. We decided to do an audit of the long-term cEEG monitoring in our NSICU over the past 7 years (2005-2011). The study was performed to determine technical and staffing consideration for the future.

Diagnostic utility of routine EEG study in identifying seizure as the etiology of the index event in patients referred with a diagnosis of migraine and not otherwise specified headache disorders.

The study investigated the diagnostic utility of a routine electroencephalogram (EEG) to help identify seizure as the underlying etiology of the index event in patients referred with a diagnosis of migraine and not otherwise specified (NOS) headache disorders. A total of 50 patients yielded 50 routine EEGs (headache NOS, n = 32; migraine n = 18). Overall, there were 37 (74%) normal EEGs and 13 (26%) abnormal.

Alien hand syndrome in Parry-Romberg syndrome.

A pediatric patient with diagnosis of Parry-Romberg syndrome, or progressive hemifacial atrophy, presented with new-onset unilateral alien hand syndrome, which was attributed to focal progressive atrophy and gliosis in the contralateral thalamus observed on serial neuroimaging. This case illustrates not only the clinical-radiographic correlation between alien hand syndrome and contralateral thalamic lesion, but also involvement of deep gray structure in Parry-Romberg syndrome causing a rare movement disorder.

Successful management of refractory neonatal seizures with midazolam.

Seizures are indicative of underlying neurologic dysfunction in neonates. Repeated seizures may be deleterious to the brain even without disturbances of ventilation or perfusion. First-line antiepileptic drugs such as phenobarbital and phenytoin are not very effective in controlling seizures in neonates.

Apneic seizures: a sign of temporal lobe hemorrhage in full-term neonates.

Intracranial hemorrhage is a common cause of neonatal seizures in full-term infants. However, only some infants with intracranial hemorrhage come to clinical attention. A right temporal lobe hemorrhage with resulting apneic seizures was described previously in one neonate.

Topiramate for the treatment of infantile spasms.

Topiramate is a new antiepileptic drug with a broad spectrum of efficacy. Reports on the use of topiramate for treatment of infantile spasms are limited. We prospectively followed 15 children with recently diagnosed infantile spasms treated with topiramate for efficacy and tolerability.

Electroencephalographic patterns in unresponsive pediatric patients.

To study the occurrence and incidence of various electroencephalographic patterns, the electroencephalograms of unresponsive pediatric patients admitted to the intensive care unit were analyzed. The interpreters were unaware of the patients' clinical diagnoses. A total of 178 electroencephalographic studies performed on unresponsive patients were analyzed over a period of 3 years.

Ketogenic diet in pediatric epilepsy patients with gastrostomy feeding.

Ketogenic diet is effective in the control of intractable seizures. Poor compliance is a major limiting factor. In one study, only 50% of children receiving the oral ketogenic diet remained on the diet after 1 year.

Nitrazepam for the treatment of Lennox-Gastaut syndrome.

Lennox-Gastaut syndrome is a severe childhood epileptic syndrome with encephalopathy and multiple seizure types, which are often intractable to treatment. Most of these children will ultimately become mentally retarded and dependent on others for their daily care. Antiepileptic drugs are the mainstay of treatment, however, no particular drug is entirely effective.