Background: The importance of simultaneous 2-lead electrocardiogram (ECG) recording during routine electroencephalogram (EEG) has been reported several times on clinical grounds. Objective: To investigate arrhythmia rates detected by simultaneous 2-lead ECG in our patient sample undergoing routine EEG. Remarkably, we sought to assess the possible expansion of results with a more experienced interpretation of simultaneous ECG. Methods: Simultaneous 2-lead ECG recordings during routine EEG, performed between January and March, 2016, have been retrospectively analyzed by a cardiology specialist. In addition, EEG reports were screened with the keywords ‘arrhythmia, tachycardia, bradycardia, atrial fibrillation, extrasystole’ to evaluate the neurologist interpretation. Results: Overall, 478 routine EEG recordings were scanned. The mean age of the patients was 42.8±19.8 (16–95), with a sex ratio of 264/214 (F/M). In 80 (17%) patients, findings compatible with arrhythmia were identified on simultaneous ECG after a cardiologist's evaluation. The detected arrhythmia subtypes were: ventricular extrasystole (n=27; 5.6%), supraventricular extrasystole (n=23; 4.8%), tachycardia (n=9; 1.8%), prolonged QRS duration (n=7; 8.7%), atrial fibrillation (n=6; 1.2%), and block (n=6; 1.2%). On the other hand, keywords related to arrhythmia were present in 45 (9.4%) of EEG reports. The reported statements were tachycardia (3.3%), arrhythmia (2.5%), bradycardia (2.1%), and extrasystole (1.5%). Conclusions: A considerably high rate of arrhythmia cases was determined on simultaneous ECG during routine EEG after being interpreted by a cardiologist. However, the screening results of EEG reports revealed relatively low arrhythmia rates. These results suggest that the detection rates of ECG abnormalities during routine EEG may be potentially improved.
BACKGROUND AND PURPOSE: Studies shows ictal behavior and symptoms are affected by patient sex in temporal lobe epilepsy. The purpose of our study was to determine whether alterations in the WM as assessed by DTI display different patterns in male and female patients with unilateral HS.
Purpose
Synthetic MRI (SyMRI) enables to quantify brain tissue and morphometry. We aimed to investigate the WM and myelin alterations in patients with unilateral hippocampal sclerosis (HS) with SyMRI.
Methods
Adult patients with isolated unilateral HS and age-matched control subjects (CSs) were included in this study. The SyMRI sequence QRAPMASTER in the coronal plane perpendicular to the hippocampi was obtained from the whole brain. Automatic segmentation of the whole brain was processed by SyMRI Diagnostic software (Version 11.2). Two neuroradiologists also performed quantitative analyses independently from symmetrical 14 ROIs placed in temporal and extratemporal WM, hippocampi, and amygdalae in both hemispheres.
Results
Sixteen patients (F/M = 6/10, mean age = 32.5 ± 11.3 years; right/left HS: 8/8) and 10 CSs (F/M = 5/5, mean age = 30.7 ± 7 years) were included. Left HS patients had significantly lower myelin and WM volumes than CSs (
p
< .05). Myelin was reduced significantly in the ipsilateral temporal lobe of patients than CSs, greater in left HS (
p
< .05). Histopathological examination including luxol fast blue stain also revealed myelin pallor in all of 6 patients who were operated. Ipsilateral temporal pole and sub-insular WM had significantly reduced myelin than the corresponding contralateral regions in patients (
p
< .05). No significant difference was found in WM values. GM values were significantly lower in hippocampi in patients than CSs (
p
< .05).
Conclusion
SyMRI revealed myelin reduction in the ipsilateral temporal lobe and sub-insular WM of patients with HS. Whether this finding correlates with electrophysiological features and SyMRI could serve as lateralization of temporal lobe epilepsy need to be investigated.
Supplementary Information
The online version contains supplementary material available at 10.1007/s00234-021-02824-6.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.