Evidentiary Significance of Routine EEG in Refractory Cases: A Paradigm Shift in Psychiatry.

Over the past decade, the 's method of prescribing medications based on presenting symptoms has been challenged. The shift toward precision medicine began with the National Institute of Mental Health and culminated with the World Psychiatric Association's posit that a paradigm shift is needed. This study supports that shift by providing evidence explaining the high rate of psychiatric medication failure and suggests a possible first step toward precision medicine.

Treating Severe Traumatic Brain Injury: Combining Neurofeedback and Hyperbaric Oxygen Therapy in a Single Case Study.

In 2014, a 26-year-old male was involved in a motor vehicle accident resulting in a severe traumatic brain injury (TBI). The patient sustained a closed-head left temporal injury with coup contrecoup impact to the frontal region. The patient underwent a left side craniotomy and was comatose for 26 days.

Clinical Application of Combined EEG-qEEG Functional Neuroimaging in the Practice of Pediatric Neuroscience: A Personal Perspective.

This brief article is an overview of my personal experience over the past almost 10 years of the clinical use of EEG and quantitative EEG (qEEG) functional neuroimaging in a busy pediatric neurology practice. The concomitant use of surface EEG and functional electromagnetic EEG neuroimaging/qEEG in clinical practice provides significant additional clinical and neurophysiologic information. The qEEG is a noninvasive, inexpensive, portable technique with high temporal resolution (milliseconds) and improving spatial resolution (down to 3 mm) and is an appropriate and validated tool for investigation of abnormal brain dynamics and connectivity of neuronal networks in clinical disorders of the brain.

Isolated epileptiform activity in children and adolescents: prevalence, relevance, and implications for treatment.

In the field of psychiatry diagnoses are primarily based on the report of symptoms from either the patient, parents, or both, and a psychiatrist's observations. A psychiatric diagnosis is currently the most widely used basis for medication selection and the brain is seldom investigated directly as a source of those symptoms. This study addresses the request from the National Institute of Mental Health (NIMH) Research Domain Criteria Project (RDoC) for scientific research into neurological abnormalities that can be linked to psychiatric symptoms for the purpose of predicting medication response.

Integration of EEG Into Psychiatric Practice: A Step Toward Precision Medicine for Autism Spectrum Disorder.

Introduction: Data from an EEG is not commonly used by psychiatrists to plan treatment and medication. However, EEG abnormalities such as isolated epileptiform discharges are found to be more prevalent in psychiatric patients, particularly those diagnosed with autism spectrum disorder (ASD). Most medications prescribed for ASD lower seizure threshold and increase side effects.

Fetal and Neonatal Effects of N-Acetylcysteine When Used for Neuroprotection in Maternal Chorioamnionitis.

Objective: To evaluate the clinical safety of antenatal and postnatal N-acetylcysteine (NAC) as a neuroprotective agent in maternal chorioamnionitis in a randomized, controlled, double-blinded trial.

Study Design: Twenty-two mothers >24 weeks gestation presenting within 4 hours of diagnosis of clinical chorioamnionitis were randomized with their 24 infants to NAC or saline treatment. Antenatal NAC (100 mg/kg/dose) or saline was given intravenously every 6 hours until delivery.

Effect of a Faith-Based Education Program on Self-Assessed Physical, Mental and Spiritual (Religious) Health Parameters.

The aim of the study was to determine the effect of attending a faith-based education program (FBEP) on self-assessed physical, mental and spiritual health parameters. The study was designed as a prospective, observational, cohort study of individuals attending a 5-day FBEP. Out of 2650 sequential online registrants, those previously unexposed to the FBEP received automated invitations to complete 5 sequential Self-Assessment Questionnaire's (SAQ's) containing: (1) Duke University Religion Index (DUREL); (2) Negative Religious Coping (N-RCOPE); (3) Perceived Stress Scale (PSS); (4) Center for Epidemiology and Statistics-Depression Scale (CES-D); (5) Brief Illness Perception Questionnaire (BIPQ); and the (6) State Trait Anxiety Inventory (STAI).

Standardized database development for EEG epileptiform transient detection: EEGnet scoring system and machine learning analysis.

The routine scalp electroencephalogram (rsEEG) is the most common clinical neurophysiology procedure. The most important role of rsEEG is to detect evidence of epilepsy, in the form of epileptiform transients (ETs), also known as spike or sharp wave discharges. Due to the wide variety of morphologies of ETs and their similarity to artifacts and waves that are part of the normal background activity, the task of ET detection is difficult and mistakes are frequently made.

Reduction of seizure occurrence from exposure to auditory stimulation in individuals with neurological handicaps: a randomized controlled trial.

Background: The purpose of this work was to determine in a clinical trial the efficacy of reducing or preventing seizures in patients with neurological handicaps through sustained cortical activation evoked by passive exposure to a specific auditory stimulus (particular music). The specific type of stimulation had been determined in previous studies to evoke anti-epileptiform/anti-seizure brain activity.

Methods: The study was conducted at the Thad E.

Web-based collection of expert opinion on routine scalp EEG: software development and interrater reliability.

Computerized detection of epileptiform transients (ETs), characterized by interictal spikes and sharp waves in the EEG, has been a research goal for the last 40 years. A reliable method for detecting ETs would assist physicians in interpretation and improve efficiency in reviewing long-term EEG recordings. Computer algorithms developed thus far for detecting ETs are not as reliable as human experts, primarily due to the large number of false-positive detections.

Sudden appearance of new upper extremity motor function while performing neurophysiologic intraoperative monitoring during tethered cord release: a case report.

Unlabelled: : Tethered cord syndrome occurs when the distal spinal cord or filum adheres to adjacent structures resulting in progressive sensorimotor deficits in the lower extremities, fecal and/or urinary incontinence, and musculoskeletal deformities. Tethering of the distal cord may be idiopathic, may be associated with an intraspinal abnormality such as a lipoma, but most commonly the distal spinal cord remnant is adherent to the area of the original dysraphism repair in patients with myelodysplasia. Surgery to untether the cord is indicated in patients with worsening pain symptoms, progressive limb deformity or spasticity, or before any acute correction of an associated spinal deformity.

Neurophysiologic intraoperative monitoring during selective dorsal rhizotomy.

Selective dorsal rootlet rhizotomy (SDR) is a neurosurgical procedure designed to reduce spasticity in the legs, although preserving motor and sensory function, of appropriately selected children with spastic quadraparesis. This is accomplished by neurophysiologicially guided (e.g.

Acute disseminated encephalomyelitis following infectious mononucleosis.

Two months following an Epstein-Barr virus infection, a 17-year-old white female presented with seizures, intermittent visual changes, and altered mental status. Magnetic resonance imaging showed white matter changes of acute disseminated encephalomyelitis with a predilection for posterior cerebral artery distributions but without radiological evidence of arteritis. Epstein-Barr virus titers and polymerase chain reaction analysis results for the virus were consistent with postinfectious acute disseminated encephalomyelitis.

Childhood paroxysmal kinesigenic dyskinesia: report of seven cases with onset at an early age.

We report on seven children who developed abnormal involuntary movements as early as 1.5 years after unremarkable term births. The paroxysmal episodes of abnormal movements were typically precipitated by sudden, voluntary movements, or a startle.

Pediatric tick paralysis: discussion of two cases and literature review.

This report describes two cases of tick paralysis in children diagnosed within a 3-month period (May-July 2002) in rural South Carolina. Differing presenting symptoms consisted of acute onset of ataxia in one patient and acute ascending paralysis in the other. Ticks were present on the scalp of both patients and were removed immediately.

The acute effect of music on interictal epileptiform discharges.

This study was a prospective, randomized, single-blinded, crossover, placebo-controlled, pilot clinical trial investigating the effect of Mozart's Sonata for Two Pianos (K448) on the frequency of interictal epileptiform discharges (IEDs) from the EEGs of children with benign childhood epilepsy with centrotemporal spikes, or "rolandic" epilepsy. The goal was to demonstrate decreased frequency of IEDs with exposure to K448. Four subjects were recruited and 4-hour awake EEG recordings performed.