To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Despite a growing understanding of disorders of consciousness following severe brain injury, the association between long-term impairment of consciousness, spontaneous brain oscillations, and underlying subcortical damage, and the ability of such information to aid patient diagnosis, remains incomplete.
Cross-sectional observational sample of 116 patients with a disorder of consciousness secondary to brain injury, collected prospectively at a tertiary center between 2011 and 2013. Multimodal analyses relating clinical measures of impairment, electroencephalographic measures of spontaneous brain activity, and magnetic resonance imaging data of subcortical atrophy were conducted in 2018.
In the final analyzed sample of 61 patients, systematic associations were found between electroencephalographic power spectra and subcortical damage. Specifically, the ratio of beta-to-delta relative power was negatively associated with greater atrophy in regions of the bilateral thalamus and globus pallidus (both left > right) previously shown to be preferentially atrophied in chronic disorders of consciousness. Power spectrum total density was also negatively associated with widespread atrophy in regions of the left globus pallidus, right caudate, and in the brainstem. Furthermore, we showed that the combination of demographics, encephalographic, and imaging data in an analytic framework can be employed to aid behavioral diagnosis.
These results ground, for the first time, electroencephalographic presentation detected with routine clinical techniques in the underlying brain pathology of disorders of consciousness and demonstrate how multimodal combination of clinical, electroencephalographic, and imaging data can be employed in potentially mitigating the high rates of misdiagnosis typical of this patient cohort.
There were several reports in Japan on cases that had characteristic features of what is now called benign adult familial myoclonic epilepsy (BAFME). Patients with BAFME often had irregular fine dysrhythmic involuntary movement, which became evident on outstretched extended arms. One of the characteristics of BAFME was giant somatosensory evoked potential (G-SEP) with enhanced long-loop cortical reflexes and premovement cortical spikes by the jerk-locked averaging method, suggesting hyperexcitability of cerebral cortex. Differential diagnosis includes a variety of progressive myoclonus epilepsy, hereditary tremor, and idiopathic epilepsies such as juvenile myoclonic epilepsy (JME) and grand mal on awaking. Careful history-taking reveals that the BAFME family history had a dominant hereditary pattern of almost complete penetrance, which is unusual for idiopathic generalized epilepsy (IGE). The presence of involuntary hand tremor with seizure strongly suggests the diagnosis of BAFME.
Email your librarian or administrator to recommend adding this to your organisation's collection.