Electrodiagnostic artifacts due to neurostimulation devices for drug resistant epilepsy
Background: Neurostimulation devices including vagus nerve stimulation (VNS), deep brain stimulation (DBS), and responsive neurostimulation (RNS) are approved therapeutic options for drug resistant epilepsy (DRE). As these devices are increasingly used in clinical practice, it is of importance to re...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Epilepsy & Behavior Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589986422000430 |
| _version_ | 1797980402840764416 |
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| author | Thaera Arafat Gadi Miron Ido Strauss Firas Fahoum |
| author_facet | Thaera Arafat Gadi Miron Ido Strauss Firas Fahoum |
| author_sort | Thaera Arafat |
| collection | DOAJ |
| description | Background: Neurostimulation devices including vagus nerve stimulation (VNS), deep brain stimulation (DBS), and responsive neurostimulation (RNS) are approved therapeutic options for drug resistant epilepsy (DRE). As these devices are increasingly used in clinical practice, it is of importance to recognize their artifacts in electrodiagnostic studies. Methods: This is a retrospective study of all adult DRE patients treated with neuromodulation devices for epilepsy at our center between 2012 and 2021. Available EEGs were reviewed for neurostimulator-related artifacts. Results: Fifty-two patients were included. 37% of patients had neurostimulation related electrophysiological artifacts (20% of VNS, 75% of DBS, all patients with dual VNS-DBS treatment, and in the single patient with RNS). Artifacts were intermittent, appearing most commonly simultaenously in the EEG and ECG. VNS artifacts were monomorphic appearing mostly in the lower temporal EEG electrodes, whereas DBS artifacts were with variable morphology, amplitude, and scalp distribution. At times, the artifacts resembled electrographic seizures in the EEG and mimicked extrasystole or asystole in the ECG. Conclusions: With the increasing use of neurostimulation treatments for DRE, and the need for frequent electrodiagnostic studies in this patient population, it is important clinicians recognize these electrophysiological findings as artifacts, to avoid misdiagnosis and facilitate accurate interpretation. |
| first_indexed | 2024-04-11T05:53:50Z |
| format | Article |
| id | doaj.art-f4f27016228c4568b5888b68753f7783 |
| institution | Directory Open Access Journal |
| issn | 2589-9864 |
| language | English |
| last_indexed | 2024-04-11T05:53:50Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Epilepsy & Behavior Reports |
| spelling | doaj.art-f4f27016228c4568b5888b68753f77832022-12-22T04:41:58ZengElsevierEpilepsy & Behavior Reports2589-98642022-01-0120100566Electrodiagnostic artifacts due to neurostimulation devices for drug resistant epilepsyThaera Arafat0Gadi Miron1Ido Strauss2Firas Fahoum3EEG and Epilepsy Unit, Neurology Department, Tel Aviv Sourasky Medical Center, 6 Weizmann, Tel Aviv 6423906, IsraelEEG and Epilepsy Unit, Neurology Department, Tel Aviv Sourasky Medical Center, 6 Weizmann, Tel Aviv 6423906, IsraelSackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; Functional Neurosurgery Unit, Neurosurgery Department, Tel Aviv Sourasky Medical Center, 6 Weizmann, Tel Aviv 6423906, IsraelEEG and Epilepsy Unit, Neurology Department, Tel Aviv Sourasky Medical Center, 6 Weizmann, Tel Aviv 6423906, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; Corresponding author at: EEG and Epilepsy Unit, Neurology Department, Tel Aviv Sourasky Medical Center, 6 Weizmann, Tel Aviv, Israel.Background: Neurostimulation devices including vagus nerve stimulation (VNS), deep brain stimulation (DBS), and responsive neurostimulation (RNS) are approved therapeutic options for drug resistant epilepsy (DRE). As these devices are increasingly used in clinical practice, it is of importance to recognize their artifacts in electrodiagnostic studies. Methods: This is a retrospective study of all adult DRE patients treated with neuromodulation devices for epilepsy at our center between 2012 and 2021. Available EEGs were reviewed for neurostimulator-related artifacts. Results: Fifty-two patients were included. 37% of patients had neurostimulation related electrophysiological artifacts (20% of VNS, 75% of DBS, all patients with dual VNS-DBS treatment, and in the single patient with RNS). Artifacts were intermittent, appearing most commonly simultaenously in the EEG and ECG. VNS artifacts were monomorphic appearing mostly in the lower temporal EEG electrodes, whereas DBS artifacts were with variable morphology, amplitude, and scalp distribution. At times, the artifacts resembled electrographic seizures in the EEG and mimicked extrasystole or asystole in the ECG. Conclusions: With the increasing use of neurostimulation treatments for DRE, and the need for frequent electrodiagnostic studies in this patient population, it is important clinicians recognize these electrophysiological findings as artifacts, to avoid misdiagnosis and facilitate accurate interpretation.http://www.sciencedirect.com/science/article/pii/S2589986422000430Vagal nerve stimulationAnterior thalamic nucleus deep brain stimulationResponsive neurostimulationArtifactEEGECG |
| spellingShingle | Thaera Arafat Gadi Miron Ido Strauss Firas Fahoum Electrodiagnostic artifacts due to neurostimulation devices for drug resistant epilepsy Epilepsy & Behavior Reports Vagal nerve stimulation Anterior thalamic nucleus deep brain stimulation Responsive neurostimulation Artifact EEG ECG |
| title | Electrodiagnostic artifacts due to neurostimulation devices for drug resistant epilepsy |
| title_full | Electrodiagnostic artifacts due to neurostimulation devices for drug resistant epilepsy |
| title_fullStr | Electrodiagnostic artifacts due to neurostimulation devices for drug resistant epilepsy |
| title_full_unstemmed | Electrodiagnostic artifacts due to neurostimulation devices for drug resistant epilepsy |
| title_short | Electrodiagnostic artifacts due to neurostimulation devices for drug resistant epilepsy |
| title_sort | electrodiagnostic artifacts due to neurostimulation devices for drug resistant epilepsy |
| topic | Vagal nerve stimulation Anterior thalamic nucleus deep brain stimulation Responsive neurostimulation Artifact EEG ECG |
| url | http://www.sciencedirect.com/science/article/pii/S2589986422000430 |
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