Cervical Radiofrequency Ablation Artifact Mimicking an Electrographic Seizure on RNS.

Autor:	Sánchez-Boluarte SS; Department of Epilepsy, Instituto Nacional de Ciencias Neurológicas, Lima, Perú., Feyissa AM; Department of Neurology, Mayo Clinic, Jacksonville, Florida, U.S.A., Freund B; Department of Neurology, Mayo Clinic, Jacksonville, Florida, U.S.A., Khan A; Department of Neurology, Mayo Clinic, Jacksonville, Florida, U.S.A., Middlebrooks EH; Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, U.S.A.; and.; Department of Radiology, Mayo Clinic, Jacksonville, Florida, U.S.A., Grewal SS; Department of Neurological Surgery, Mayo Clinic, Jacksonville, Florida, U.S.A.; and., Tatum WO; Department of Neurology, Mayo Clinic, Jacksonville, Florida, U.S.A.
Jazyk:	angličtina
Zdroj:	Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society [J Clin Neurophysiol] 2023 Jul 01; Vol. 40 (5), pp. 478-480. Date of Electronic Publication: 2023 Apr 17.
DOI:	10.1097/WNP.0000000000000989
Abstrakt:	Summary: The responsive neurostimulator continuously monitors the electrocorticogram. It delivers short bursts of high-frequency electrical stimulation when personalized patterns are detected. Intracranial EEG recording including electrocorticography is susceptible to artifacts, albeit at a lesser frequency compared with scalp recording. The authors describe a novel case of a patient with focal epilepsy, bitemporal responsive neurostimulation, and seizures without self-awareness manifest as focal impaired awareness seizures adversely affecting memory. At follow-up evaluation, the patient reported being clinically seizure-free although a single long episode was detected using the Patient Data Management System over the course of 3 years. Initial review identified a left-sided rhythmic discharge with a bilateral spatial field of involvement. In response to detection, the responsive neurostimulation delivered a series of five electrical stimulations. On further review, the patient recalled undergoing cervical radiofrequency ablation, which coincided with the appearance of the "electrographic seizure." Extrinsic electrical artifact involving monomorphic nonevolving waveforms confirmed electrical artifact identified and treated by responsive neurostimulation as an epileptic seizure. On rare occasion, implanted electrical devices may lead to misdiagnosis and mistreatment of patients because of intracranial artifact. Competing Interests: The authors have no funding or conflicts of interest to disclose. (Copyright © 2023 by the American Clinical Neurophysiology Society.)
Databáze:	MEDLINE
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