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Seizure ; 64: 45-49, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30554130


PURPOSE: To evaluate the clinical utility of the ambulatory electroencephalogram (AEEG) in children. METHOD: Data from 199 consecutive referrals for a paediatric AEEG were reviewed retrospectively. Information was gathered on various aspects of the referral process, the characteristics of the children referred and the reasons for referral. Clinical utility was calculated as the percentage of cases in which the investigation provided useful information with respect to the question asked of the test. RESULTS: The AEEG was useful in 64.8% cases overall. In 51.4% of cases the reason for referral was to capture events, however the test was only useful in 42.6% of these. The most common reason for an unsuccessful investigation was failure to capture events (55.6%). Suspected encephalopathy with status epilepticus during sleep (ESES) was the indication in a substantial number of cases (38.6%), and the investigation was useful in most of these (97.5%). Technical issues were only responsible for 7 (9.7%) of unsuccessful studies. CONCLUSION: The paediatric AEEG was useful in two thirds of patients. Failure to capture events appears to be the most significant limiting factor. The AEEG is very useful in investigating suspected ESES.

Eletroencefalografia/normas , Epilepsia/diagnóstico , Monitorização Ambulatorial/normas , Sono/fisiologia , Estado Epiléptico/diagnóstico , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Adulto Jovem
Eur Spine J ; 26(8): 2103-2111, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-27554347


PURPOSE: To compare measurements of motor evoked potential latency stimulated either magnetically (mMEP) or electrically (eMEP) and central motor conduction time (CMCT) made pre-operatively in conscious patients using transcranial and intra-operatively using electrical cortical stimulation before and after successful instrumentation for the treatment of adolescent idiopathic scoliosis. METHODS: A group initially of 51 patients with adolescent idiopathic scoliosis aged 12-19 years was evaluated pre-operatively in the outpatients' department with transcranial magnetic stimulation. The neurophysiological data were then compared statistically with intra-operative responses elicited by transcranial electrical stimulation both before and after successful surgical intervention. MEPs were measured as the cortically evoked compound action potentials of Abductor hallucis. Minimum F-waves were measured using conventional nerve conduction methods and the lower motor neuron conduction time was calculated and this was subtracted from MEP latency to give CMCT. RESULTS: Pre-operative testing was well tolerated in our paediatric/adolescent patients. No neurological injury occurred in any patient in this series. There was no significant difference in the values of mMEP and eMEP latencies seen pre-operatively in conscious patients and intra-operatively in patients under anaesthetic. The calculated quantities mCMCT and eCMCT showed the same statistical correlations as the quantities mMEP and eMEP latency. CONCLUSIONS: The congruency of mMEP and eMEP and of mCMCT and eCMCT suggests that these measurements may be used comparatively and semi-quantitatively for the comparison of pre-, intra-, and post-operative spinal cord function in spinal deformity surgery.

Potencial Evocado Motor , Monitorização Neurofisiológica Intraoperatória/métodos , Assistência Perioperatória/métodos , Escoliose/cirurgia , Estimulação Magnética Transcraniana , Adolescente , Criança , Estimulação Elétrica , Feminino , Humanos , Masculino , Escoliose/fisiopatologia , Resultado do Tratamento , Adulto Jovem