Jeavons Syndrome, Eyelid Myoclonus with Absences (EMA) with Epileptic Status and Hypoactive Delirium

The evaluation of electroencephalogram (EEG) and the clinical picture of eyelid myoclonus (EM) with absences (EMA) using classical EEG signal evaluation and power spectral analysis currently presents a major challenge to predict further improvement, unsteady status, neurological defect outcomes in patients, or lethal termination in septic encephalopathy and acid-base imbalance due to kidney failure. At the Clinic of Anaesthesiology and Intensive Medicine (CAIM) of University Hospital in Martin (UHM) we clinically examined a patient N.J., a 58-year-old male with EMA. We used the Neuron-Spectrum-AM specialized software to measure the EEG signal visually and by means of power spectral analysis methods to quantitatively analyse the EEG record

Instantaneous EEG signal analysis based on empirical mode decomposition applied to burst-suppression in propofol anaesthesia

The human electroencephalogram (EEG) constitutes a nonstationary, nonlinear electrophysiological signal resulting from synchronous firing of neurons in thalamocortical structures of the brain. Due to the complexity of the brain's physiological structures and its rhythmic oscillations, analysis of EEG often utilises spectral analysis methods. Aim: to improve clinical monitoring of neurophysiological signals and to further explain basic principles of functional mechanisms in the brain during anaesthesia. Material and methods. In this paper we used Empirical Mode decomposition (EMD), a novel spectral analysis method especially suited for nonstationary and nonlinear signals. EMD and the related Hilbert-Huang Transform (HHT) decompose signal into constituent Intrinsic Mode Functions (IMFs). In this study we applied EMD to analyse burst-suppression (BS) in the human EEG during induction of general anaesthesia (GA) with propofol. BS is a state characterised by cyclic changes between significant depression of brain activity and hyper-active bursts with variable duration, amplitude, and waveform shape. BS arises after induction into deep general anaesthesia after an intravenous bolus of general anaesthetics. Here we studied the behaviour of BS using the burst-suppression ratio (BSR). Results. Comparing correlations between EEG and IMF BSRs, we determined BSR was driven mainly by alpha activity. BSRs for different spectral components (IMFs 1-4) showed differing rates of return to baseline after the end of BS in EEG, indicating BS might differentially impair neural generators of low-frequency EEG oscillations and thalamocortical functional connectivity. Conclusion. Studying BS using EMD represents a novel form of analysis with the potential to elucidate neurophysiological mechanisms of this state and its impact on post-operative patient prognosis

Electrical Changes in Deeper Cortical Structures During Balanced General Anesthesia with the Aim on Inhalation Anesthetics Effects

There are many theories that attempt to explain the mechanisms of the effects of inhalation anesthetics - from simpler, pursuing individual effects of anesthetics on the level of the ion channels, to more complex that are looking for uniform global changes in brain activity common to several agents. However, we still don’t have satisfactory and adequate conclusions

Pharmacological treatments

peer reviewedWe review the current state of knowledge of potentially useful drugs acting on the recovery of consciousness in severely brain-damaged patients. Exploratory and retrospective studies as well as case reports on the sporadic cases of recovery are discussed regarding pharmacological treatments such as amantadine, levodopa, bromocriptine, apomorphine, methylphenidate, zolpidem, baclofen, and lamotrigine. Potential underlying mechanisms explaining the effects of these drugs on the awakening and recovery of consciousness in this challenging population are also examined. Finally, we discuss the process of using single-subject methods to assess the off-label use of a specific medication. © Springer International Publishing AG 2018