A5021768389- Epilepsy research and treatment
- EEG and Brain-Computer Interfaces
- Neonatal and fetal brain pathology
- Neuroscience and Neuropharmacology Research
- Traumatic Brain Injury and Neurovascular Disturbances
- Autoimmune Neurological Disorders and Treatments
- Infectious Encephalopathies and Encephalitis
- Pharmacological Effects and Toxicity Studies
- Intracerebral and Subarachnoid Hemorrhage Research
- Acute Ischemic Stroke Management
- Cardiac Arrest and Resuscitation
- Hemodynamic Monitoring and Therapy
- Long-Term Effects of COVID-19
- Peripheral Neuropathies and Disorders
- Intensive Care Unit Cognitive Disorders
- Genetics and Neurodevelopmental Disorders
- Cardiac electrophysiology and arrhythmias
- Neuroscience and Music Perception
- Ion channel regulation and function
- Neural dynamics and brain function
- Non-Invasive Vital Sign Monitoring
- RNA regulation and disease
- Neurobiology of Language and Bilingualism
- Liver Disease and Transplantation
- Neurological Complications and Syndromes
Cleveland Clinic
2016-2025
The Neurological Institute
2017-2024
Yale New Haven Hospital
2024
Rhode Island Hospital
2024
Harvard University
2020
Beth Israel Deaconess Medical Center
2020
Collaborative Research Group
2019
Cleveland Clinic Lerner College of Medicine
2016
Case Western Reserve University
2016
University of Chicago
2015
The aims of this study were to determine the etiology, clinical features, and predictors outcome new-onset refractory status epilepticus. Retrospective review patients with epilepticus without etiology identified within 48 hours admission between January 1, 2008, December 31, 2013, in 13 academic medical centers. primary measure was poor functional at discharge (defined as a score >3 on modified Rankin Scale). Of 130 cases, 67 (52%) remained cryptogenic. most common etiologies autoimmune...
The coronavirus disease of 2019 (COVID-19) emerged as a global pandemic. Historically, the group human coronaviruses can also affect central nervous system leading to neurological symptoms; however, causative mechanisms manifestations COVID-19 are not well known. Seizures have been directly reported part outside patients with previously known brain injury or epilepsy. We report two cases acute symptomatic seizures, in non-epileptic patients, associated severe disease.Two advanced-age,...
<h3>Objective:</h3> To evaluate the sensitivity of quantitative EEG (QEEG) for electrographic seizure identification in intensive care unit (ICU). <h3>Methods:</h3> Six-hour epochs chosen from 15 patients underwent transformation into QEEG displays. Each epoch was reviewed 3 formats: raw EEG, + raw, and QEEG-only. Epochs were also analyzed by a proprietary detection algorithm. Nine neurophysiologists EEGs to identify seizures serve as gold standard. other with experience evaluated formats,...
Abstract Febrile infection‐related epilepsy syndrome (FIRES) is a subset of new onset refractory status epilepticus (NORSE) that involves febrile infection prior to the epilepticus. It unclear whether FIRES and non‐FIRES NORSE are distinct conditions. Here, we compare 34 patients with 30 for demographics, clinical features, neuroimaging, outcomes. Because were younger than (median = 28 vs. 48 years old, p .048) more likely cryptogenic (odds ratio 6.89), next ran regression analysis using age...
Stroke patients who underwent continuous EEG (cEEG) monitoring within 7 days of presentation and developed post-stroke epilepsy (PSE; cases, n = 36) were matched (1:2 ratio) by age follow-up duration with ones did not (controls, 72). Variables significant on univariable analysis [hypertension, smoking, hemorrhagic conversion, pre-cEEG convulsive seizures, epileptiform abnormalities (EAs)] included in the multivariable logistic model only presence EAs remained PSE predictor [OR 11.9...
Electrographic seizures detected by continuous electroencephalography (CEEG) in critically ill patients with altered mental status is becoming increasingly recognized. Data guiding the appropriate selection of to be monitored on CEEG are lacking. The aims this article were study incidence critical care setting and evaluate for clinical predictors improve efficiency monitoring.Retrospective review data 1,123 consecutive who had video EEG over a 24-month period.Seizures recorded 215 monitoring...
To risk-stratify electrographic features of lateralized periodic discharges (LPDs) in acute structural brain lesions for predictors seizures.This is a retrospective review 100 consecutive patients with LPDs. Epileptiform LPDs were described based on features: blunt delta morphology, sharply contoured, overlying fast frequencies, and/or rhythmicity (loss interdischarge interval lasting ≥1 second). EEG seizures defined as evolving frequency, distribution, or morphology at ≥2 Hz ≥10...
Abstract In response to the evolving treatment landscape for new‐onset refractory status epilepticus (NORSE) and publication of consensus recommendations in 2022, we conducted a comparative analysis NORSE management over time. Seventy‐seven patients were enrolled by 32 centers, from July 2016 August 2023, NORSE/FIRES biorepository at Yale. Immunotherapy was administered 88% after median 3 days, with 52% receiving second‐line immunotherapy 12 days (anakinra 29%, rituximab 25%, tocilizumab...
To identify factors, especially the electrographic features, that predispose patients with lateralized periodic discharges (LPDs) to epilepsy development. We included adults, without history, who had LPDs on continuous EEG (cEEG) monitoring during hospitalization. characterized based American Clinical Neurophysiology Society rhythmic and pattern modifiers. The outcome variable was development as defined by clinical seizure after discharge. used a Cox regression model calculate adjusted...
ABSTRACT Objective Post‐discharge management and outcomes of acute symptomatic seizures (ASyS) remain underexplored. We analyzed post‐discharge ASM in ASyS patients undergoing continuous EEG (cEEG), including the role outpatient care through a post‐acute seizure (PASS) clinic. Methods performed single‐center, retrospective study adults without epilepsy discharged on ASMs due to witnessed or suspected 2019. A cause‐specific cumulative distribution function was used estimate outcome...
Pharmacologic sedation is often used to induce burst suppression in cases of refractory status epilepticus, but there little evidence guide the weaning sedation. Similarly, morphologic feature bursts unknown clinical relevance. Recently, standardized American Clinical Neurophysiology Society terminology critical care EEG introduced term highly epileptiform (HEBs). Knowing association HEBs with seizure may direct therapy for epilepticus.Consecutive adult patients classified as having were...
Summary Objective To evaluate the incidence of new onset epilepsy and associated risk factors in patients with periodic patterns on continuous electroencephalography ( cEEG ) during critical illness. Methods The local database then medical records were reviewed from January 1, 2013 to June 30, find adult no history who had discharges—either lateralized LPD s) or generalized GPD s)—or nonperiodic/nonepileptogenic NP / NE findings ≥3 months clinical follow‐up. Clinical seizure after discharge...
New-onset refractory status epilepticus is a clinical condition characterized by acute and prolonged pharmacoresistant seizures without pre-existing relevant neurologic disorder, prior epilepsy, or clear structural, toxic, metabolic cause. often associated with antineuronal antibodies may respond to early immunosuppressive therapy, reflecting an inflammatory element of the condition. FDG-PET useful diagnostic tool in noninflammatory encephalitis. We report here findings new-onset their...
Abstract Objective This study was designed to investigate if highly epileptic electroencephalogram (EEG) findings in patients with acute brain injury increase the long‐term risk of epilepsy development. Methods Adults patients, lacking history, electrographic seizures or lateralized periodic discharges (LPDs) (cases) were identified and matched based on age, mental status, etiology ones any epileptiform activity (controls) continuous EEG (cEEG) during hospitalization. The primary outcome...
Acute symptomatic seizures are frequent in the critically ill patient and can be difficult to treat. The novel anticonvulsant perampanel may effective treatment of status epilepticus considering its mechanism action being an AMPA antagonist. We present four cases super refractory treated with high dose perampanel.Case report.Four patients were for their epilepticus. One had new onset unknown etiology. Three other as a result cardiac arrest. Two arrest myoclonus. In all patients, additional...
Background and ObjectivesMost acute symptomatic seizure (ASyS) patients stay on antiseizure medications (ASM) long-term, despite low epilepsy development risk. The Post-Acute Symptomatic Seizure (PASS) clinic is a transition of care model for ASyS who individualize ASM management with the goal safe deprescription. We evaluated discharged ASMs after witnessed or suspected to analyze their PASS visit attendance its predictors.MethodsA single-center, retrospective cohort study adults without...
Abstract Caveolin‐1 is the principal structural and functional component of caveolae, a plasmalemmal compartment that has been proposed to sequester lipid protein components participate in transmembrane signal transduction processes. Multiple studies reveal reduction expression level caveolin‐1 mRNA many carcinomas as well transformed cells. The human gene localized suspected tumor suppressor locus (7q31.1). Collectively, these data have taken imply may function capacity. To determine if...