Syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL): A case report with serial electroencephalography (EEG) recordings.. Is there an association with human herpes virus type 7 (HHV-7) infection?

Introduction The syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) is a diagnosis made by exclusion. In the literature, different etiological explanations are proposed for HaNDL, including an immune-mediated reaction after a viral infection. Case description We present a case of a 23-year-old woman with several episodes of transient headache, neurological deficits and cerebrospinal fluid lymphocytosis.

Affair With Triphasic Waves-Their Striking Presence, Mysterious Significance, and Cryptic Origins: What are They?

Triphasic waves, which have been recorded in the EEG of encephalopathy for more than 50 years, remain clearly identifiable but historically purportedly of uncertain significance. Initially described with liver failure and high serum ammonias, they came to be reported in an ever-expanding list of metabolic, toxic, and structural conditions. Often a dynamic finding (in which the occurrence of triphasic waves might increase or decrease with stimulation or arousal of the patient during EEG), there has been increasing insight into their correlation with multiple concurrent conditions, including subcortical white-matter disease, infections and metabolic disturbances, and their prognostic significance.

Stimulus-induced reflex epileptic spasms in 5p- syndrome.

Here we describe two patients with 5p- syndrome who suffered from epilepsy characterised by stimulus-induced epileptic spasms manifesting as head nodding. In patient 1, a series of spasms were exclusively triggered by eating, and were associated with diffuse high-voltage slow waves on ictal EEG, particularly presenting as a positive slow potential at the left mid-temporal area. Clusters of sharp waves with negative polarity emerged in the same area during the inter-spasm periods during eating.

Generalized periodic discharges and 'triphasic waves': A blinded evaluation of inter-rater agreement and clinical significance.

Objectives: Generalized periodic discharges (GPDs) are associated with nonconvulsive seizures. Triphasic waves (TWs), a subtype of GPDs, have been described in relation to metabolic encephalopathy and not felt to be associated with seizures. We sought to establish the consistency of use of this descriptive term and its association with seizures.

Ictal and interictal EEG patterns in patients with nonconvulsive and subtle convulsive status epilepticus.

Background: Electroencephalography findings in nonconvulsive or subtle convulsive status epilepticus (NCSE and SCSE, respectively) can be heterogenous. We aimed to study the different patterns on EEG in our cohort of patients.

Objective: Our objective was to study ictal and interictal EEG patterns in patients with NCSE and SCSE.

Response Rates to Anticonvulsant Trials in Patients with Triphasic-Wave EEG Patterns of Uncertain Significance.

Background: Generalized triphasic waves (TPWs) occur in both metabolic encephalopathies and non-convulsive status epilepticus (NCSE). Empiric trials of benzodiazepines (BZDs) or non-sedating AED (NSAEDs) are commonly used to differentiate the two, but the utility of such trials is debated. The goal of this study was to assess response rates of such trials and investigate whether metabolic profile differences affect the likelihood of a response.

Atypical sporadic CJD-MM phenotype with white matter kuru plaques associated with intranuclear inclusion body and argyrophilic grain disease.

We describe an atypical neuropathological phenotype of sporadic Creutzfeldt-Jakob disease in a 76-year-old man. The clinical symptoms were characterized by progressive dementia, gait ataxia, rigidity and urinary incontinence. The disease duration was 6 weeks.

Nonconvulsive status epilepticus and Creutzfeldt-Jakob-like EEG changes in a case of lithium toxicity.

We report a case of a 63-year-old lady with bipolar affective disorder on lithium who was brought to our emergency center in a comatose state. Neurologically, the patient was comatose and had generalized hypotonia and hyporeflexia. Lithium toxicity was considered.

Correlates of a single cortical action potential in the epidural EEG.

To identify the correlates of a single cortical action potential in surface EEG, we recorded simultaneously epidural EEG and single-unit activity in the primary somatosensory cortex of awake macaque monkeys. By averaging over EEG segments coincident with more than hundred thousand single spikes, we found short-lived (≈ 0.5 ms) triphasic EEG deflections dominated by high-frequency components >800 Hz.

A study of clinical profile, radiological and electroencephalographic characteristics of suspected Creutzfeldt-Jakob disease in a tertiary care centre in South India.

Introduction: Creutzfeldt-Jakob disease (CJD) is a progressive, fatal, neurodegenerative disease classified under transmissible spongiform encephalopathies (TSE) or prion diseases. It is characterized by long asymptomatic period followed by rapid clinical deterioration leading to the death within months. The disease is still under-reported in India.

Clinical neurophysiological assessment of sepsis-associated brain dysfunction: a systematic review.

Introduction: Several studies have reported the presence of electroencephalography (EEG) abnormalities or altered evoked potentials (EPs) during sepsis. However, the role of these tests in the diagnosis and prognostic assessment of sepsis-associated encephalopathy remains unclear.

Methods: We performed a systematic search for studies evaluating EEG and/or EPs in adult (≥ 18 years) patients with sepsis-associated encephalopathy.

Electroencephalographic changes in sporadic Creutzfeldt-Jakob disease and correlation with clinical stages: a retrospective analysis.

Purpose: To analyze clinical features and EEG changes in patients with sporadic Creutzfeldt-Jakob disease and study the association between different EEG patterns and clinical stages.

Methods: We retrospectively analyzed the clinical features and EEG patterns of 3 patients with clinical stage II and 10 patients with stage III sporadic Creutzfeldt-Jakob disease (EEG n = 17). Chi-square test was used to study the association between EEG features and disease stages.

Focal triphasic sharp waves and spikes in the electroencephalogram.

There is a plethora of data in the EEG literature on the characteristics of the most prominent component of interictal epileptiform discharges (IED), namely the negative (fast) phase. Surprisingly, however, little attention has been drawn to the after-coming slow wave (ASW), and its pathological as well as clinical significance. In this paper, we will address the significance of prominent (high amplitude) ASW, giving rise to a triphasic morphology of the IED (focal triphasic sharp waves and spikes—FTSW).

Interrater agreement for Critical Care EEG Terminology.

Objective: The interpretation of critical care electroencephalography (EEG) studies is challenging because of the presence of many periodic and rhythmic patterns of uncertain clinical significance. Defining the clinical significance of these patterns requires standardized terminology with high interrater agreement (IRA). We sought to evaluate IRA for the final, published American Clinical Neurophysiology Society (ACNS)-approved version of the critical care EEG terminology (2012 version).

Application of subhairline EEG montage in intensive care unit: comparison with full montage.

Purpose: Problems with the availability of standard EEG monitoring in the intensive care unit have led to the use of recordings that have limited spatial coverage. We studied the performance of limited coverage EEG compared with more traditional full-montage EEG.

Methods: Continuous EEG recordings were performed on 170 patients using the full-montage 10-20 placement of electrodes as a reference recording and an abbreviated montage of electrodes applied below the hairline (subhairline).

Recurring hyperammonemic encephalopathy induced by bacteria usually not producing urease.

Background: Hyperammonemic encephalopathy may occur when urease-positive bacteria in the urinary tract produce ammonium which directly enters systemic circulation. Predisposing conditions such as a neurogenic bladder can increase both urinary tract infection and urine stagnation.

Case Presentation: We describe the case of a 66 years old woman with a neurogenic bladder who twice developed hyperammonemic encephalopathy following urinary tract infection.

Sporadic Creutzfeldt-Jakob disease (sCJD) with asymmetric findings.

We report a case of a patient with probable Creutzfeldt-Jakob disease (CJD) who had psychiatric manifestation in the form of withdrawn depressive behaviour at the onset, followed by rapidly progressive ataxia, parkinsonism, mutism and cognitive decline with generalised asynchronous multifocal myoclonic jerks. His EEG exhibited focal (lateralised) periodic triphasic sharp waves on the background of generalised delta slowing, which later on became more generalised. MRI of the brain showed hyperintensity in basal ganglia with cortical ribbon sign in bilateral frontal region.

Uncovering clinical and radiological associations of triphasic waves in acute encephalopathy: a case-control study.

Background And Purpose: Triphasic waves (TWs) are archetypal waveforms seen on electroencephalography (EEG) in some forms of encephalopathy. Their particular underlying pathological substrates are largely unexplored. This case-control study was designed to identify and quantify specific clinical and neuroradiological associations underlying TWs and to determine if TWs predicate outcome.

Ifosfamide related encephalopathy: the need for a timely EEG evaluation.

Background: Ifosfamide is an alkylating agent useful in the treatment of a wide range of cancers including sarcomas, lymphoma, gynecologic and testicular cancers. Encephalopathy has been reported in 10-40% of patients receiving high-dose IV ifosfamide.

Objective: To highlight the role of electroencephalogram (EEG) in the early detection and management of ifosfamide related encephalopathy.

Significance of triphasic waves in patients with acute encephalopathy: a nine-year cohort study.

Objective: Triphasic waves (TWs) are a frequent electroencephalography (EEG) finding in encephalopathy, yet their origin and prognostic significance are not well understood. The aim of this study was to determine the clinical and EEG characteristics in encephalopathic patients with TWs. We hypothesized that specific EEG characteristics are predictive of outcome.