Out-of-hospital multimodal seizure detection: a pilot study.

Background: Out-of-hospital seizure detection aims to provide clinicians and patients with objective seizure documentation in efforts to improve the clinical management of epilepsy. In-patient studies have found that combining different modalities helps improve the seizure detection accuracy. In this study, the objective was to evaluate the viability of out-of-hospital seizure detection using wearable ECG, accelerometry and behind-the-ear electroencephalography (EEG).

Lyme neuroborreliosis presenting with urinary retention and spastic paraparesis.

Progressive myelopathy, urinary retention and gait problems are rare presenting features of Lyme neuroborreliosis. A 30-year-old man had 11 months of urinary retention and 3 months of spastic paraparesis. MR scans of the brain and the spinal cord showed leptomeningeal thickening with contrast enhancement.

Systematic Review of EEG Coherence in Alzheimer's Disease.

Background: Magnitude-squared coherence (MSCOH) is an electroencephalography (EEG) measure of functional connectivity. MSCOH has been widely applied to investigate pathological changes in patients with Alzheimer's disease (AD). However, significant heterogeneity exists between the studies using MSOCH.

Towards a wearable multi-modal seizure detection system in epilepsy: A pilot study.

Objective: To explore the possibilities of wearable multi-modal monitoring in epilepsy and to identify effective strategies for seizure-detection.

Methods: Thirty patients with suspected epilepsy admitted to video electroencephalography (EEG) monitoring were equipped with a wearable multi-modal setup capable of continuous recording of electrocardiography (ECG), accelerometry (ACM) and behind-the-ear EEG. A support vector machine (SVM) algorithm was trained for cross-modal automated seizure detection.

Pitfalls in EEG Analysis in Patients With Nonconvulsive Status Epilepticus: A Preliminary Study.

Electroencephalography (EEG) interpretations through visual (by human raters) and automated (by computer technology) analysis were still not reliable for the diagnosis of nonconvulsive status epilepticus (NCSE). This study aimed to identify typical pitfalls in the EEG analysis and make suggestions as to how those pitfalls might be avoided. We analyzed the EEG recordings of individuals who had clinically confirmed or suspected NCSE.

Fully automatic peak frequency estimation of the posterior dominant rhythm in a large retrospective hospital EEG cohort.

Objective: To develop and test a fully automated method for estimation of the peak frequency of the posterior dominant rhythm (PDR) in a large retrospective EEG cohort.

Methods: Thresholding was used to select suitable EEG data segments for spectral estimation for electrode O1 and O2. A random sample of 100 peak frequency estimates were blindly rated by two independent raters to validate the results of the automatic PDR peak frequency estimates.

A new era in electroencephalographic monitoring? Subscalp devices for ultra-long-term recordings.

Inaccurate subjective seizure counting poses treatment and diagnostic challenges and thus suboptimal quality in epilepsy management. The limitations of existing hospital- and home-based monitoring solutions are motivating the development of minimally invasive, subscalp, implantable electroencephalography (EEG) systems with accompanying cloud-based software. This new generation of ultra-long-term brain monitoring systems is setting expectations for a sea change in the field of clinical epilepsy.

Gamma Entrainment in a Large Retrospective Cohort: Implications for Photic Stimulation Therapy for Alzheimer's Disease.

Background: Studies on mice models of Alzheimer's disease (AD) have suggested potential therapeutic benefits of intermittent photic stimulation at 40 Hz.

Objective: We examined the physiological response of 40 Hz intermittent photic stimulation (IPS) on routine EEG in a large retrospective cohort to investigate the effects of age on induced gamma oscillations by intermittent photic stimulation. Since most AD patients are elderly, it is important for future research to know if age affects photic stimulation.

Quantitative characteristics of spike-wave paroxysms in genetic generalized epilepsy.

Objective: To characterize generalized spike-wave paroxysms (GSW) in children with generalized genetic epilepsy (GGE).

Methods: We annotated 15-19 channel scalp EEGs from a retrospective cohort from patients with a variety of GGE syndromes. Connectivity, entropy, frequency, power, spike-amplitudes were compared with a normal baseline activity and analyzed for the effect of age and sex.

Subcutaneous EEG Monitoring Reveals AED Response and Breakthrough Seizures.

Unrecognized seizures are a common problem in temporal lobe epilepsy potentially leading to undertreatment. Objective seizure counting using EEG home monitoring for prolonged periods with a minimally invasive device has not been feasible until now. We present a case in which a novel, subcutaneous EEG device was utilized to provide an objective seizure count.

Ear-EEG-based sleep scoring in epilepsy: A comparison with scalp-EEG.

Ear-EEG is a wearable electroencephalogram-recording device. It relies on recording electrodes that are nested within a custom-fitted earpiece in the external ear canal. The concept has previously been tested for seizure detection in epileptic patients and for sleep recordings in a healthy population.

Event marker compliance in actigraphy.

Actigraphy is a versatile tool for evaluating sleep-wake cycles over time in the home-environment. Patients using the Phillips Actiwatch place an event marker when going to sleep and upon awakening. We investigate compliance in pressing the Actiwatch event marker button for patients referred for insomnia, hypersomnia and disorders of circadian rhythm.

Postictal EEG changes following focal seizures: Interrater agreement and comparison to frequency analysis.

Objectives: To compare frequency analysis to human raters and determine the interrater agreement of postictal EEG changes after focal seizures.

Methods: 24 focal seizures with and without impaired awareness recorded with scalp-EEG in the epilepsy monitoring unit were selected. Five board-certified neurophysiologists annotated seizure termination and end of postictal changes for all seizures.

Modulation of task-related cortical connectivity in the acute and subacute phase after stroke.

The functional relevance of cortical reorganization post-stroke is still not well understood. In this study, we investigated task-specific modulation of cortical connectivity between neural oscillations in key motor regions during the early phase after stroke. EEG and EMG recordings were examined from 15 patients and 18 controls during a precision grip task using the affected hand.

Corticomuscular coherence in the acute and subacute phase after stroke.

Objective: Stroke is one of the leading causes of physical disability due to damage of the motor cortex or the corticospinal tract. In the present study we set out to investigate the role of adaptations in the corticospinal pathway for motor recovery during the subacute phase after stroke.

Methods: We examined 19 patients with clinically diagnosed stroke and 18 controls.