Status epilepticus in patients with juvenile myoclonic epilepsy: Frequency, precipitating factors and outcome

Status epilepticus (SE) is rarely described in patients with juvenile myoclonic epilepsy (JME), and little is known about its frequency, subtypes, and predictors and the prognosis of these patients. In this retrospective study, we aimed to analyze the incidence of SE in patients with JME and emphasize the risk factors and long-term outcome of SE in an epilepsy outpatient-based cohort

Peri-ictal Prone Position Is Associated With Independent Risk Factors For Sudden Unexpected Death In Epilepsy: A Controlled Video-EEG Monitoring Unit Study

Introduction. Sudden unexpected death in epilepsy (SUDEP) is a major cause of death in patients with chronic drug-resistant epilepsy, and peri-ictal prone position has been elucidated as a risk factor for SUDEP. We aimed to investigate consecutive patients in peri-ictal prone positions in our video EEG monitoring (VEM) unit and compare patients with and without peri-ictal prone position to emphasize its relationship with other independent risk factors for SUDEP. Methods. We retrospectively screened all patients with peri-ictal prone position who underwent VEM for a 10-year period and these patients constituted the prone (+) group. All patients without peri-ictal prone position who underwent VEM in the past 2 years constituted the prone (-) control group. Sequences of peri-ictal positions and interventions were evaluated. Clinical and laboratory features and SUDEP-7 scores were compared between the groups. Results. A total of 21 seizures were identified with peri-ictal prone position from 16 patients. SUDEP-7 scores were significantly higher in the prone (+) group. Longer duration of epilepsy, early age at seizure onset, mental retardation, and frequency of seizures of any type (>50 seizures per month for the past year) were found significantly different between the prone (+) and prone (-) groups. Conclusion. Peri-ictal prone position in the VEM unit may relate with other independent risk factors of SUDEP, especially with mental retardation. Nocturnal supervision becomes important to reduce SUDEP risk, especially in patients with mental retardation

An algorithm for automatic detection of repeater F-waves and MUNE studies

The present study aims to develop an algorithm and software that automatically detects repeater F-waves which are very difficult to analyze when elicited as high number of recordings in motor unit number estimation studies. The main strategy of the study was to take the repeater F waves discriminated by the neurologist, from limited number of recordings, as the gold standard and to test the conformity of the results of the new automated method

Automatic Analysis of CMAP Scan Data on Healthy Controls and Motor Neuron Patients

In this study, motor response recordings were acquired from thenar and hypothenar muscles of poliomyelitis survivors, ALS patients and healthy participants by using CMAP Scan method. CMAP Scan curve was plotted by using 500 stimuli between minimum and maximum stimulus intensity. Automatic analysis software was developed with MATLAB for calculating CMAP Scan parameters. Statistical results revealed that step%, D50 and returner% values can differentiate healthy individuals from the patients. The developed software helps clinicians for following up the progression rate of the diseases which cause anterior horn cell degeneration

EVALUATION OF REPETITIVE NERVE STIMULATION WITH DIFFERENT STIMULATION FREQUENCIES IN PATIENTS WITH MYASTHENIA GRAVIS

Objective: To investigate the effect of voluntary contraction at low frequency repetitive nerve stimulation (RNS) as a sign of presynaptic compensation in patients with Myasthenia Gravis (MG)

The persistence versus interchangeability of migraine and tension-type headaches in a 5-year population-based validated survey.

Objective The aim of this population-based validated study was to determine the course of tension-type headache and migraine and to evaluate the predictors of persistence. Methods We evaluated the course of headache in a large population from the first assessment in 2008 through a second assessment in 2013. Then we examined the factors associated with persistent migraine and persistent tension-type headache. Results Our study in 2013 revealed that only 42.9% of definite migraineurs in 2008 received the same diagnosis again, and of the remaining migraineurs 23.3% were newly diagnosed as definite tension-type headache; 11.6% evolved into probable tension-type headache, 6.4% changed to probable migraine, and 15.8% were headache free. The 17.7% of patients with definite tension-type headache in 2008 were newly diagnosed as having probable tension-type headache, 14.7% as having definite migraine, 6.4% as having probable migraine, and 28.9% as headache free in 2013, and only 32.3% received the definite tension-type headache diagnosis again. Binary logistic regression analysis showed nausea, throbbing and severe headache were the significant parameters for persistent migraine. A multiple regression analysis model with stepwise variable selection revealed that nausea, throbbing and severe headache and osmophobia remained in the final model as predictors of migraine persistence. We found no predictive factor for persistent tension-type headache. Conclusion Migraine and tension-type headache did not seem to show a simple bidirectional linear worsening from headache-free state to definite migraine or vice versa, hence the transitions between them are more chaotic, reflecting that there are still unknown modifiers and modulators. Certain headache characteristics of migraine might predict persistent migraine

Compound muscle action potential scan and MScanFit motor unit number estimation during Wallerian degeneration after nerve transections

WOS: 000537273700001PubMed: 32415858Background Compound muscle action potential (CMAP) scan and MScanFit have been used to understand the consequences of denervation and reinnervation. This study aimed to monitor these parameters during Wallerian degeneration (WD) after acute nerve transections (ANT). Methods Beginning after urgent surgery, CMAP scans were recorded at 1-2 day intervals in 12 patients with ANT of the ulnar or median nerves, by stimulating the distal stump (DS). Stimulus intensities (SI), steps, returners, and MScanFit were calculated. Studies were grouped according to the examination time after ANT. Results were compared with those of 27 controls. Results CMAP amplitudes and MScanFit progressively declined, revealing a positive correlation with one another. SIs were higher in WD groups than controls. Steps appeared or disappeared in follow-up scans. the late WD group had higher returner% than the early WD and control groups. Conclusions MScanFit can monitor neuromuscular dysfunction during WD. SIs revealed excitability changes in DS.University College LondonUniversity College Londo

Repeater F-waves in amyotrophic lateral sclerosis: Electrophysiologic indicators of upper or lower motor neuron involvement?

sirin, Nermin Gorkem/0000-0001-8792-2929;WOS: 000502603500012PubMed: 31760213Objective: To extract insight about the mechanism of repeater F-waves (Frep) by exploring their correlation with electrophysiologic markers of upper and lower motor neuron dysfunction in amyotrophic lateral sclerosis (ALS). Methods: the correlations of Frep parameters with clinical scores and the results of neurophysiological index (NI), MScanfit MUNE, F/M amplitude ratio (F/M%), single and paired-pulse transcranial magnetic stimulation (TMS), and triple stimulation technique (TST) studies, recorded from abductor digiti minimi (ADM) and abductor pollicis brevis (APB) muscles of 35 patients with ALS were investigated. Results: Frep parameters were correlated with NI and MScanfit MUNE in ADM muscle and F/M% in both muscles. None of the Frep parameters were correlated with clinical scores or TST and TMS measures. While the CMAP amplitudes were similar in the two recording muscles, there was a more pronounced decrease of F-wave persistence in APB, probably heralding the subsequent split hand phenomenon. Conclusion: Our findings suggest that the presence and density of Freps are primarily related to the degree of lower motor neuron loss and show no correlation with any of the relatively extensive set of parameters for upper motor neuron dysfunction. Significance: Freps are primarily related to lower motor neuron loss in ALS. (C) 2019 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved