Dementia, Subtype of Seizures, and the Risk of New Onset Seizures: A Cohort Study.

Background: Seizure disorders have been identified in patients suffering from different types of dementia. However, the risks associated with the seizure subtypes have not been characterized.

Objective: To compare the occurrence and risk of various seizure subtypes (focal and generalized) between patients with and without a dementia diagnosis.

Motor unit number estimation of facial muscles using the M Scan-Fit method.

Introduction: M Scan-Fit, an automated method for motor unit number estimation (MUNE), was assessed in muscles innervated by the facial nerve.

Methods: Healthy volunteers were recruited. M Scans were recorded twice from nasalis and depressor anguli oris (DAO) muscles, and then fitted to a probabilistic model.

Reference values of upper extremity nerve conduction studies in a Colombian population.

Objective: To establish appropriate reference values of upper extremity nerve conduction studies (NCS) at the Del Valle University Hospital, from Colombia.

Methods: Two hundred and twenty-two (N = 222) healthy volunteers were recruited. Latencies, amplitudes and conduction velocities from the Median, Ulnar, and Radial nerves were performed following recommendations from Buschbacher and Prahlow.

Purulent infectious myositis (formerly tropical pyomyositis).

Purulent infectious myositis (PIM), formerly known as tropical pyomyositis, is a pyogenic infection of skeletal muscles. Staphylococcus aureus, a normal human skin inhabitant, is the main pathogen involved, but multiple other microorganisms have been implicated. Although usually a progressive febrile disease with pain in the affected muscle(s), severe, life-threatening forms have been described, especially in immunosuppressed patients and children.

Initial absence of N20 waveforms from median nerve somatosensory evoked potentials in a patient with cardiac arrest and good outcomes.

A 34-year-old male was brought to the hospital with a chest gunshot wound. Pulseless upon arrival, blood pressure was absent for 10 minutes. A thoracotomy resulted in return of spontaneous circulation.

Diagnostic Accuracy of Somatosensory Evoked Potential Monitoring in Evaluating Neurological Complications During Endovascular Aneurysm Treatment.

Background: Somatosensory evoked potential (SSEP) monitoring is used extensively for early detection and prevention of neurological complications in patients undergoing many different neurosurgical procedures. However, the predictive ability of SSEP monitoring during endovascular treatment of cerebral aneurysms is not well detailed.

Objective: To evaluate the performance of intraoperative SSEP in the prediction postprocedural neurological deficits (PPNDs) after coil embolization of intracranial aneurysms.

Brainstem Auditory Evoked Potentials' Diagnostic Accuracy for Hearing Loss: Systematic Review and Meta-Analysis.

 Microvascular decompression (MVD) utilizes brainstem auditory evoked potential (BAEP) intraoperative monitoring to reduce the risk of iatrogenic hearing loss. Studies report varying efficacy and hearing loss rates during MVD with intraoperative monitoring.  This study aims to perform a comprehensive review and study of diagnostic accuracy of BAEPs during MVD to predict hearing loss in studies published from January 1984 to December 2013.

Intraoperative Neurophysiological Monitoring of the Laryngeal Nerves During Anterior Neck Surgery: A Review.

Contributions to the literature on intraoperative neuro monitoring (IONM) during endocrine and head and neck surgery have increased over recent years. Organizational support for neural monitoring during surgery is becoming evident and is increasingly recognized as an adjunct to visual nerve identification. A comprehensive understanding of the role of IONM for prevention of nerve injuries is critical to maximize safety during surgery of the anterior compartment of the neck.

Diagnostic Accuracy of Somatosensory Evoked Potentials in Evaluating New Neurological Deficits After Posterior Cervical Fusions.

Study Design: This study examined the diagnostic accuracy of significant changes of somatosensory evoked potentials (SSEPs) to evaluate and predict postoperative neurological deficits after posterior cervical fusions (PCF). Eight hundred forty six eligible patients underwent PCF at the University of Pittsburgh Medical Center (UPMC), from 2010 to 2012.

Objective: To assess the specificity and sensitivity of intraoperative monitoring in predicting postoperative neurological deficits during PCF.

Diagnostic accuracy of somatosensory evoked potential and electroencephalography during carotid endarterectomy.

Background And Purpose: Perioperative stroke risk following carotid endarterectomy (CEA) is reported to be approximately 2-3%. The diagnostic accuracies of intraoperative EEG and SSEP monitoring during CEA have been studied separately. However, to date, the effectiveness of simultaneous EEG and SSEP monitoring during CEA has only been evaluated in small study populations.

Comparison of Subdermal Needle and Surface Adhesive Stimulating Electrodes for Somatosensory Evoked Potential Monitoring during Anterior Cervical Discectomy and Fusion.

Introduction: Needle stick injuries remain a physical and psychological burden to healthcare workers. Noninvasive surface adhesive stimulating electrodes used to generate somatosensory evoked potentials can help decrease this risk.

Methods: We performed a retrospective observational study of patients who underwent anterior cervical discectomy and fusion (ACDF) surgery to determine the utility and variability of using surface adhesive stimulating electrodes.

Comorbid Medical Conditions in Vascular Dementia: A Matched Case-Control Study.

The objective of the study was to compare the presence of comorbid medical conditions between patients with a vascular dementia (VaD) and a control group, from the Integrated Healthcare Information Services (IHCIS) database. VaD was defined by the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes 290.40, 290.

Reduction in high-frequency hearing loss following technical modifications to microvascular decompression for hemifacial spasm.

Object: Microvascular decompression is a safe and effective procedure to treat hemifacial spasm, but the operation poses some risk to the patient's hearing. While severe sensorineural hearing loss across all frequencies occurs at a low rate in experienced hands, a recent study suggests that as many as one-half of patients who undergo this procedure may experience ipsilateral high-frequency hearing loss (HFHL), and as many as one-quarter may experience contralateral HFHL. While it has been suggested that drill-related noise may account for this finding, this study was designed to examine the effect of a number of techniques designed to protect the vestibulocochlear nerve from operative manipulation on the incidence of HFHL.

Hearing outcomes after loss of brainstem auditory evoked potentials during microvascular decompression.

The primary aim of this paper is to study the pre-operative characteristics, intra-operative changes and post-operative hearing outcomes in patients after complete loss of wave V of the brainstem auditory evoked potential. We retrospectively analyzed the brainstem auditory evoked potential data of 94 patients who underwent microvascular decompression for hemifacial spasm at our institute. Patients were divided into two groups - those with and those without loss of wave V.

Risk factors for cranial nerve deficits during carotid endarterectomy: a retrospective study.

Background: Cranial nerve deficits during CEA are a known complication. The purpose of this study is to evaluate if significant changes in somatosensory evoked potentials and electroencephalography increase cranial nerve deficits during CEA.

Procedures: This is an observational retrospective case-control study analyzed with data collected from patients who underwent CEA at the University of Pittsburgh Medical Center.

Diagnostic value of somatosensory evoked potential changes during carotid endarterectomy: a systematic review and meta-analysis.

Importance: Perioperative stroke is a persistent complication of carotid endarterectomy (CEA) for patients with symptomatic carotid stenosis (CS).

Objective: To evaluate whether changes in somatosensory evoked potential (SSEP) during CEA are diagnostic of perioperative stroke in patients with symptomatic CS.

Design, Setting, And Participants: We searched PubMed and the World Science Database for reference lists of retrieved studies and/or experiments on SSEP use in postoperative outcomes following CEA in patients with symptomatic CS from January 1, 1950, through January 1, 2013.

Diagnostic accuracy of brainstem auditory evoked potentials during microvascular decompression.

Objective: The primary aim of the study was to assess the sensitivity and specificity of intraoperative monitoring in predicting postoperative hearing loss during microvascular decompression (MVD).

Methods: The study was designed as an examination of the diagnostic accuracy of brainstem evoked potentials compared with reference standard for nonserviceable hearing loss (Class C/D), which is a change of more than 50 dB on pure tone threshold, and change of speech discrimination score of more than 50. All patients underwent surgery and audiograms at a University of Pittsburgh Medical Center facility in the study period 2005-2012.

Appropriate time to establish baseline responses for brain stem auditory evoked potentials during microvascular decompression for hemifacial spasm.

Purpose: To evaluate the appropriate time to establish baseline responses for brain stem auditory evoked potentials (BAEPs) during microvascular decompression for hemifacial spasm and its implications on the alarm criteria and outcomes.

Methods: Overall, 61 patients who had intraoperative monitoring with BAEP during microvascular decompression were retrospectively identified. The latencies and amplitudes of wave V before skin incision and at dura opening (before major manipulation) were compared with the latency and amplitude of wave V at change start (first alarm reported to the surgeon).

Intraoperative neurophysiological monitoring of microvascular decompression for glossopharyngeal neuralgia.

Purpose: To evaluate if adding cranial nerves (CNs) V and VI to standard intraoperative neurophysiological monitoring (IONM) of microvascular decompressions for glossopharyngeal neuralgia improve its efficacy.

Methods: We reviewed all patients who received a microvascular decompression for glossopharyngeal neuralgia at our institution between January 2008 and August 2012. All received upper extremity somatosensory evoked potentials, brainstem auditory evoked potentials, and free-running electromyography of muscles innervated by ipsilateral CNs VII, IX, and X.

Analysis of wave III of brain stem auditory evoked potential waveforms during microvascular decompression of cranial nerve VII for hemifacial spasm.

Introduction: Intraoperative monitoring of brain stem auditory evoked potential during microvascular decompression (MVD) prevent hearing loss (HL). Previous studies have shown that changes in wave III (wIII) are an early and sensitive sign of auditory nerve injury.

Objective: To evaluate the changes of amplitude and latency of wIII of brain stem auditory evoked potential during MVD and its association with postoperative HL.

Somatosensory-evoked potential monitoring during instrumented scoliosis corrective procedures: validity revisited.

Background: Intraoperative monitoring (IOM) using somatosensory-evoked potentials (SSEPs) plays an important role in reducing iatrogenic neurologic deficits during corrective pediatric idiopathic procedures for scoliosis. However, for unknown reasons, recent reports have cited that the sensitivity of SSEPs to detect neurologic deficits has decreased, in some to be less than 50%. This current trend, which is coincident with the addition of transcranial motor-evoked potentials, is surprising given that SSEPs are robust, reproducible responses that were previously shown to have sensitivity and specificity of >90%.

Different neurological conditions between urban and rural samples from central Colombia.

Objectives: Despite availability of neuroepidemiological data, urban-rural differences on neurological diseases have almost never been considered. Our goal is to identify differences in the frequency of neurological conditions between a rural and an urban sample from central Colombia.

Methods: We compared frequencies of neurological encounters of an urban sample from Bogotá (N=2932), to our rural sample from Tunja (N=2664), collected both circa to 2000.

Neurophysiologic intraoperative monitoring of olfactory and optic nerves.

Olfaction and vision are two sensory functions that can be lost during surgery. Intraoperative neurophysiologic monitoring can be used to monitor the integrity of the olfactory and the visual pathways during surgery. No objective methods have been established to test olfactory evoked potentials (OEPs) in the operating room.

Effect of botulinum neurotoxin treatment in the lateral spread monitoring of microvascular decompression for hemifacial spasm.

Introduction: Botulinum neurotoxin (BtNtx) treatment for hemifacial spasm (HFS) prior to microvascular decompression (MVD) is hypothesized to be a factor in the variability of intraoperative neurophysiological monitoring (IONM) during this procedure.

Methods: We analyzed 282 MVDs performed at the University of Pittsburgh Medical Center between January 1, 2000 and December 31, 2007. We retrospectively compared the lateral spread response (LSR) in the mentalis muscle when stimulus-triggered electromyography (EMG) was elicited from the facial nerve.

Microvascular decompression for hemifacial spasm: evaluating outcome prognosticators including the value of intraoperative lateral spread response monitoring and clinical characteristics in 293 patients.

Hemifacial spasm is a socially disabling condition that manifests as intermittent involuntary twitching of the eyelid and progresses to muscle contractions of the entire hemiface. Patients receiving microvascular decompression of the facial nerve demonstrate an abnormal lateral spread response (LSR) in peripheral branches during facial electromyography. The authors retrospectively evaluate the prognostic value of preoperative clinical characteristics and the efficacy of intraoperative monitoring in predicting short- and long-term relief after microvascular decompression for hemifacial spasm.