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Book ; Online ; E-Book: Hirsch and Brenner's atlas of EEG in critical care

Hirsch, Lawrence J. / Fong, Michael W.K. / Brenner, Richard P.

2023

Title variant	Atlas of EEG in critical care
Author's details	edited by Lawrence J. Hirsch, Michael W. K. Fong, Richard P. Brenner
Keywords	Electronic books ; Electroencephalography / methods ; Critical Care
Language	English
Size	1 Online-Ressource (xi, 556 Seiten), Illustrationen, Diagramme
Edition	Second edition
Publisher	Wiley Blackwell
Publishing place	Chichester
Publishing country	Great Britain
Document type	Book ; Online ; E-Book
Remark	Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
HBZ-ID	HT021687859
ISBN	978-1-118-75286-9 ; 978-1-118-75287-6 ; 9781118752890 ; 1-118-75286-4 ; 1-118-75287-2 ; 1118752899
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Editorial: Seizure disorders: 2023 update.

Hirsch, Lawrence J

Current opinion in neurology

2023 Volume 36, Issue 2, Page(s) 59–60

MeSH term(s)	Humans ; Epilepsy/diagnosis ; Epilepsy/therapy
Language	English
Publishing date	2023-02-06
Publishing country	England
Document type	Introductory Journal Article
ZDB-ID	1182686-1
ISSN	1473-6551 ; 1350-7540
ISSN (online)	1473-6551
ISSN	1350-7540
DOI	10.1097/WCO.0000000000001139
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Book: Atlas of EEG in critical care

Hirsch, Lawrence J. / Brenner, Richard P.

2010

Author's details	Lawrence J. Hirsch ; Richard P. Brenner
Keywords	Electroencephalography / methods ; Critical Care ; Intensive Care ; Electroencephalography ; Neurological intensive care ; Neurophysiologic monitoring
Subject code	616.80428
Language	English
Size	XI, 334 S. : überw. Ill.
Publisher	Wiley-Blackwell
Publishing place	Oxford
Publishing country	Great Britain
Document type	Book
HBZ-ID	HT016221857
ISBN	978-0-4709-8786-5 ; 0-4709-8786-3
Database	Catalogue ZB MED Medicine, Health

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2010 C 9	order for loan	Magazin

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Article: A practical approach to in-hospital management of new-onset refractory status epilepticus/febrile infection related epilepsy syndrome.

Sheikh, Zubeda / Hirsch, Lawrence J

Frontiers in neurology

2023 Volume 14, Page(s) 1150496

Abstract: New-onset refractory status epilepticus (NORSE) is "a clinical presentation, not a specific diagnosis, in a patient without active epilepsy or other preexisting relevant neurological disorder, with new onset of refractory status epilepticus without a ... ...

Abstract	New-onset refractory status epilepticus (NORSE) is "a clinical presentation, not a specific diagnosis, in a patient without active epilepsy or other preexisting relevant neurological disorder, with new onset of refractory status epilepticus without a clear acute or active structural, toxic, or metabolic cause." Febrile infection related epilepsy syndrome (FIRES) is "a subcategory of NORSE that requires a prior febrile infection, with fever starting between 2 weeks and 24 h before the onset of refractory status epilepticus, with or without fever at the onset of status epilepticus." These apply to all ages. Extensive testing of blood and CSF for infectious, rheumatologic, and metabolic conditions, neuroimaging, EEG, autoimmune/paraneoplastic antibody evaluations, malignancy screen, genetic testing, and CSF metagenomics may reveal the etiology in some patients, while a significant proportion of patients' disease remains unexplained, known as NORSE of unknown etiology or cryptogenic NORSE. Seizures are refractory and usually super-refractory (i.e., persist despite 24 h of anesthesia), requiring a prolonged intensive care unit stay, often (but not always) with fair to poor outcomes. Management of seizures in the initial 24-48 h should be like any case of refractory status epilepticus. However, based on the published consensus recommendations, the first-line immunotherapy should begin within 72 h using steroids, intravenous immunoglobulins, or plasmapheresis. If there is no improvement, the ketogenic diet and second-line immunotherapy should start within seven days. Rituximab is recommended as the second-line treatment if there is a strong suggestion or proof of an antibody-mediated disease, while anakinra or tocilizumab are recommended for cryptogenic cases. Intensive motor and cognitive rehab are usually necessary after a prolonged hospital stay. Many patients will have pharmacoresistant epilepsy at discharge, and some may need continued immunologic treatments and an epilepsy surgery evaluation. Extensive research is in progress now via multinational consortia relating to the specific type(s) of inflammation involved, whether age and prior febrile illness affect this, and whether measuring and following serum and/or CSF cytokines can help determine the best treatment.
Language	English
Publishing date	2023-05-12
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2023.1150496
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Do acute EEG findings add to clinical features in predicting outcomes after status epilepticus and acute symptomatic seizures?

Sivaraju, Adithya / Hirsch, Lawrence J

Epilepsy & behavior : E&B

2023 Volume 141, Page(s) 109134

Abstract: Status epilepticus is a potentially life-threatening medical emergency associated with poor functional outcomes. Improving our ability to accurately predict functional outcomes is beneficial to optimizing treatment strategies. Currently, there are four ... ...

Abstract	Status epilepticus is a potentially life-threatening medical emergency associated with poor functional outcomes. Improving our ability to accurately predict functional outcomes is beneficial to optimizing treatment strategies. Currently, there are four published status epilepticus scores in adults: STESS (Status Epilepticus Severity Score), EMSE (Epidemiology-Based Mortality Score in Status Epilepticus), END-IT (Encephalitis-Nonconvulsive-Diazepam resistance-Imaging-Tracheal intubation), and recently published ACD (Age-level of Consciousness-Duration of status epilepticus) score. The only available scale in the pediatric population is PEDSS (Pediatric CPC scale-EEG (normal vs abnormal)-Drug refractoriness-critical Sickness-Semiology). While these scores are useful research tools, currently there is little evidence to suggest their utility during real-time clinical care. Except for EMSE, none of the scores incorporate EEG findings for prognostication. Adding EEG features improves prognostic accuracy, as has been shown with the EMSE scale with and without the EEG component. Acute symptomatic seizures (AsyS) and early epileptiform abnormalities, especially nonconvulsive seizures, and periodic discharges, markedly increase the risk for subsequent unprovoked seizures. However, many of these patients may not need lifelong anti-seizure medications (ASMs). Continuous EEG monitoring shows that the majority of ASyS are nonconvulsive and can identify epileptic patterns. Dedicated specialty clinics for these patients, known as Post Acute Symptomatic Seizure (PASS) clinics, already exist in the United States. Post Acute Symptomatic Seizure clinics are ideal for both long-term clinical care and answering important research questions related to epileptogenesis, duration of ASM treatment required, and evolution of EEG findings. This topic was presented at the 8th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures held in September 2022. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
MeSH term(s)	Child ; Adult ; Humans ; Status Epilepticus/diagnosis ; Status Epilepticus/etiology ; Status Epilepticus/therapy ; Prognosis ; Epilepsy ; Long-Term Care ; Electroencephalography
Language	English
Publishing date	2023-02-26
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2010587-3
ISSN	1525-5069 ; 1525-5050
ISSN (online)	1525-5069
ISSN	1525-5050
DOI	10.1016/j.yebeh.2023.109134
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Article ; Online: Second-line immunotherapy in new onset refractory status epilepticus.

Hanin, Aurélie / Muscal, Eyal / Hirsch, Lawrence J

Epilepsia

2024

Abstract: Several pieces of evidence suggest immune dysregulation could trigger the onset and modulate sequelae of new onset refractory status epilepticus (NORSE), including its subtype with prior fever known as febrile infection-related epilepsy syndrome (FIRES). ...

Abstract	Several pieces of evidence suggest immune dysregulation could trigger the onset and modulate sequelae of new onset refractory status epilepticus (NORSE), including its subtype with prior fever known as febrile infection-related epilepsy syndrome (FIRES). Consensus-driven recommendations have been established to guide the initiation of first- and second-line immunotherapies in these patients. Here, we review the literature to date on second-line immunotherapy for NORSE/FIRES, presenting results from 28 case reports and series describing the use of anakinra, tocilizumab, or intrathecal dexamethasone in 75 patients with NORSE. Among them, 52 patients were managed with anakinra, 21 with tocilizumab, and eight with intrathecal dexamethasone. Most had elevated serum or cerebrospinal fluid cytokine levels at treatment initiation. Treatments were predominantly initiated during the acute phase of the disease (92%) and resulted, within the first 2 weeks, in seizure control for up to 73% of patients with anakinra, 70% with tocilizumab, and 50% with intrathecal dexamethasone. Cytokine levels decreased after treatment for most patients. Anakinra and intrathecal dexamethasone were mainly initiated in children with FIRES, whereas tocilizumab was more frequently prescribed for adults, with or without a prior febrile infection. There was no clear correlation between the response to treatment and the time to initiate the treatment. Most patients experienced long-term disability and drug-resistant post-NORSE epilepsy. Initiation of second-line immunotherapies during status epilepticus (SE) had no clear effect on the emergence of post-NORSE epilepsy or long-term functional outcomes. In a small number of cases, the initiation of anakinra or tocilizumab several years after SE onset resulted in a reduction of seizure frequency for 67% of patients. These data highlight the potential utility of anakinra, tocilizumab, and intrathecal dexamethasone in patients with NORSE. There continues to be interest in the utilization of early cytokine measurements to guide treatment selection and response. Prospective studies are necessary to understand the role of early immunomodulation and its associations with epilepsy and functional outcomes.
Language	English
Publishing date	2024-03-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/epi.17933
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Article ; Online: Updated review of rescue treatments for seizure clusters and prolonged seizures.

Blond, Benjamin N / Hirsch, Lawrence J

Expert review of neurotherapeutics

2022 Volume 22, Issue 7, Page(s) 567–577

Abstract: Introduction: Although the treatment of epilepsy primarily focuses on prevention, recurrent seizures are unfortunately an ongoing reality, particularly in people with epilepsy who live with chronic refractory seizures. Rescue medications are agents ... ...

Abstract	Introduction: Although the treatment of epilepsy primarily focuses on prevention, recurrent seizures are unfortunately an ongoing reality, particularly in people with epilepsy who live with chronic refractory seizures. Rescue medications are agents which can be administered in urgent/emergent seizure episodes such as seizure clusters or prolonged seizures with the goal of terminating seizure activity, preventing morbidity, and decreasing the risk of further seizures. Areas covered: This review first discusses clinical opportunities for rescue medications, with particular attention focused on seizure clusters and prolonged seizures, including their epidemiology, risk factors, and associated morbidity. Current rescue medications, their indications, efficacy, and adverse effects are discussed. We then discuss rescue medications and formulations which are currently under development, concentrating on practical aspects relevant for clinical care. Expert opinion: Rescue medications should be considered for all people with epilepsy with ongoing seizures. Recent rescue medications including intranasal formulations provide considerable advantages. New rescue medications are being developed which may expand opportunities for effective treatment. In the future, combining rescue medications with seizure detection and seizure prediction technologies should further expand opportunities for use and should reduce the morbidity of seizures and provide increased comfort, control, and quality of life for people living with epilepsy.
MeSH term(s)	Anticonvulsants/therapeutic use ; Epilepsy/drug therapy ; Epilepsy, Generalized/drug therapy ; Humans ; Quality of Life ; Seizures/drug therapy ; Status Epilepticus/drug therapy
Chemical Substances	Anticonvulsants
Language	English
Publishing date	2022-07-26
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2112534-X
ISSN	1744-8360 ; 1473-7175
ISSN (online)	1744-8360
ISSN	1473-7175
DOI	10.1080/14737175.2022.2105207
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Article: Applications of SPECT/CT in the Evaluation of Spinal Pathology: A Review.

Hirsch, Brandon P / Sossamon, Jake / Khan, Monis A / Reitman, Charles / Lawrence, James P / Glaser, John / Chun, Rebecca / Gerald, Brittany / Baron, Eli / Goldstein, Theodore / Baaj, Ali A / Patrick Johnson, J / Elojeimy, Saeed / Ravinsky, Robert A

International journal of spine surgery

2024 Volume 18, Issue 1, Page(s) 9–23

Language	English
Publishing date	2024-03-04
Publishing country	Netherlands
Document type	Journal Article
ISSN	2211-4599
ISSN	2211-4599
DOI	10.14444/8552
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Article: The Cost of After-Hour Electroencephalography.

Ney, John P / Nuwer, Marc R / Hirsch, Lawrence J / Burdelle, Mark / Trice, Kellee / Parvizi, Josef

Neurology. Clinical practice

2024 Volume 14, Issue 2, Page(s) e200264

Abstract: Background and objectives: High costs associated with after-hour electroencephalography (EEG) constitute a barrier for financially constrained hospitals to provide this neurodiagnostic procedure outside regular working hours. Our study aims to deepen ... ...

Abstract	Background and objectives: High costs associated with after-hour electroencephalography (EEG) constitute a barrier for financially constrained hospitals to provide this neurodiagnostic procedure outside regular working hours. Our study aims to deepen our understanding of the cost elements involved in delivering EEG services during after-hours. Methods: We accessed publicly available data sets and created a cost model depending on 3 most commonly seen staffing scenarios: (1) technologist on-site, (2) technologist on-call from home, and (3) a hybrid of the two. Results: Cost of EEG depends on the volume of testing and the staffing plan. Within the various cost elements, labor cost of EEG technologists is the predominant expenditure, which varies across geographic regions and urban areas. Discussion: We provide a model to explain why access to EEGs during after-hours has a substantial expense. This model provides a cost calculator tool (made available as part of this publication in eAppendix 1, links.lww.com/CPJ/A513) to estimate the cost of EEG platform based on site-specific staffing scenarios and annual volume.
Language	English
Publishing date	2024-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2645818-4
ISSN	2163-0933 ; 2163-0402
ISSN (online)	2163-0933
ISSN	2163-0402
DOI	10.1212/CPJ.0000000000200264
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Article ; Online: Patient-detectable responsive neurostimulation as a seizure warning system.

Quraishi, Imran H / Hirsch, Lawrence J

Epilepsia

2021 Volume 62, Issue 7, Page(s) e110–e116

Abstract: Many people with epilepsy are not aware of their seizures or do not have reliable auras. The responsive neurostimulation system (RNS) delivers stimulation triggered by intracranial epileptiform activity. If an epileptiform pattern continues, the RNS ... ...

Abstract	Many people with epilepsy are not aware of their seizures or do not have reliable auras. The responsive neurostimulation system (RNS) delivers stimulation triggered by intracranial epileptiform activity. If an epileptiform pattern continues, the RNS repeats stimulation up to five times per event. The RNS can cause acute stimulation-related symptoms that can be avoided by reducing stimulation. Because each of the five therapies can be programmed independently, it may be possible to program the latter therapies to induce a seizure warning. The goal of this study was to determine what proportion of patients could have tolerable symptoms safely elicited by stimulation, ultimately for the purpose of subjective seizure recognition. Of 18 patients, 12 (67%) had induced symptoms, which were tolerable in 11. Phosphenes were most common. We also present one patient in whom the fifth therapy was set to induce a symptom for early recognition and treatment of clusters of focal impaired awareness seizures, which were previously unrecognized and had led to days of disabling cognitive impairment. This protocol prevented disabling clusters successfully for several years. The findings suggest the RNS can provide a seizure warning, potentially improving safety and quality of life, and leading to prevention of clinical seizures or clusters in select patients.
MeSH term(s)	Adult ; Clinical Alarms ; Electrocorticography ; Electrodes, Implanted ; Epilepsy/etiology ; Female ; Hippocampus ; Humans ; Implantable Neurostimulators ; Male ; Middle Aged ; Phosphenes ; Predictive Value of Tests ; Quality of Life ; Seizures/diagnosis ; Visual Fields
Language	English
Publishing date	2021-05-20
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/epi.16933
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