Sylvie Nguyen

The American clinical neurophysiology society's guideline on continuous electroencephalography monitoring in neonates

This article offers the preferred methods and indications for longterm, conventional electroencephalography (EEG) monitoring for selected, high-risk neonates of postmenstrual age less than 48 weeks. The authors recognize that there may be significant practical barriers to the implementation of these recommendations for many caregivers and institutions, particularly with regard to the availability of equipment, and technical and interpretive personnel. A wide range of clinical circumstances dictates the implementation of EEG monitoring, frequency of EEG review, and the subsequent treatment of seizures or EEG background abnormalities detected by neonatal EEG. Consequently, this article should be considered as an expression of idealized goals and not as a mandated standard of care.

American clinical neurophysiology society standardized EEG terminology and categorization for the description of continuous EEG monitoring in neonates: report of the American Clinical Neurophysiology Society critical care monitoring committee.

BACKGROUNDCritically ill neonates are at high risk for adverse neurologic sequelae, but the bedside evaluation of a neonates neurologic status, especially cortical functioning, is extremely limited. In such circumstances, continuous video EEG provides particularly useful information about brain

Functional MRI comparison of passive and active movement: possible inhibitory role of supplementary motor area.

Recent studies have hypothesized that the supplementary motor area plays a role in motor inhibition. To study this possible role, we used functional MRI study to compare conditions, which require various level of inhibition of motor patterns. Seventeen healthy participants were scanned while executing – actively or passively – rhythmic opening/closing movements of their right hand, with and without congruent visual information. The contrast passive>active movement in the visual guidance condition which requires inhibition in order ‘not’ to perform the movement, yields to significant activation of areas commonly involved in the inhibitory brain circuitry among which, notably, controlateral supplementary motor area.

Specificities of Awake Craniotomy and Brain Mapping in Children for Resection of Supratentorial Tumors in the Language Area.

BACKGROUND In the pediatric population, awake craniotomy began to be used for the resection of brain tumor located close to eloquent areas. Some specificities must be taken into account to adapt this method to children. OBJECTIVE The aim of this clinical study is to not only confirm the feasibility of awake craniotomy and language brain mapping in the pediatric population but also identify the specificities and necessary adaptations of the procedure. METHODS Six children aged 11 to 16 were operated on while awake under local anesthesia with language brain mapping for supratentorial brain lesions (tumor and cavernoma). The preoperative planning comprised functional magnetic resonance imaging (MRI) and neuropsychologic and psychologic assessment. The specific preoperative preparation is clearly explained including hypnosis conditioning and psychiatric evaluation. The success of the procedure was based on the ability to perform the language brain mapping and the tumor removal without putting the patient to sleep. We investigated the pediatric specificities, psychological experience, and neuropsychologic follow-up. RESULTS The children experienced little anxiety, probably in large part due to the use of hypnosis. We succeeded in doing the cortical-subcortical mapping and removing the tumor without putting the patient to sleep in all cases. The psychological experience was good, and the neuropsychologic follow-up showed a favorable evolution. CONCLUSIONS Preoperative preparation and hypnosis in children seemed important for performing awake craniotomy and contributing language brain mapping with the best possible psychological experience. The pediatrics specificities are discussed.

A new virtual reality tool for unilateral cerebral palsy rehabilitation: two single-case studies.

Abstract Objective: To examine the “clinical utility” of a new virtual rehabilitation tool in order to treat upper-limb motor deficit in cerebral palsy (CP) patient. Methods: Single-case experimental designs. Virtual reality intervention was performed in two left unilateral spastic CP adolescent patients. The virtual reality intervention was given for 60 minutes per session, two sessions a day, and 5 days a week over 2 weeks. Results: For each patient and for both hands, the number of blocks transported within one minute (box and block test scores) is increased. The nonoverlap of all pairs indices for the paretic hand were calculated as 0.95 for subject 1 and 0.93 for subject 2, and the nonoverlap of all pairs indices for the nonparetic hand were calculated, respectively, as 0.92 and 1. Conclusion: We provide empirical evidence in support of a new simple Virtual Rehabilitation system in CP patient to improve upper-limb motor function.

Relationship between somatosensory deficit and brain somatosensory system after early brain lesion: A morphometric study.

Cerebral Palsy (CP) is a group of permanent motor disorders due to non-progressive damage to the developing brain. Poor tactile discrimination is common in children with unilateral CP. Previous findings suggest the crucial role of structural integrity of the primary (S1) and secondary (S2) somatosensory areas located in the ipsilesional hemisphere for somatosensory function processing. However, no focus on the relationship between structural characteristics of ipsilesional S1 and S2 and tactile discrimination function in paretic hands has been proposed. Using structural MRI and a two-point discrimination assessment (2 PD), we explore this potential link in a group of 21 children (mean age 13 years and 7 months) with unilateral CP secondary to a periventricular white matter injury (PWMI) or middle cerebral artery infarct (MCA). For our whole sample there was a significant negative correlation between the 2 PD and the gray matter volume in the ipsilesional S2 (rho = -0.50 95% confidence interval [-0.76, -0.08], one-tailed p-value = 0.0109) and in the ipsilesional S1 (rho = -0.57, 95% confidence interval [-0.81, -0.19], one-tailed p-value = 0.0032). When studying these relationships with regard to the lesion types, we found these correlations were non-significant in the patients with PWMI but stronger in patients with MCA. According to our results, the degree of sensory impairment is related to the spared gray matter volume in ipsilesional S1 and S2 and is marked after an MCA stroke. Our work contributes to a better understanding of why some patients with CP have variable somatosensory deficit following an early brain lesion.

Data Analysis Tool for Arm Movement Pattern in Virtual Catching Task: A Preliminary Development

This paper describes the development of our virtual reality based rehabilitation system for children with cerebral palsy (CP). This system was designed to facilitate intrinsic motivation of CP patients for a rehabilitation exercise by integrating a gamification framework. In a previous study, we identified patients strategy changes during the rehabilitation task involving catching. The aim of this study is to develop a data-mining framework that utilizes results from the previous study coupled with real-time visualization and data generation to further the understanding of the strategy changes during the catching task. In this paper, we describe a result of a preliminary development of the proposed framework.