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Reduction of EEG Myogenic Artifact with Botulinum Toxin during Video-EEG Monitoring.

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Title: Reduction of EEG Myogenic Artifact with Botulinum Toxin during Video-EEG Monitoring.
Authors: Grant, Arthur C., Hermanowicz, Neal
Source: Epilepsia (Series 4). Feb2007, Vol. 48 Issue 2, p324-329. 6p. 2 Charts, 3 Graphs.
Subjects: Botulinum toxin, Electroencephalography, Injections, Spasms, Myoblasts
Abstract: Purpose: To determine whether EEG myogenic artifact during video-EEG monitoring (VEM) is reduced with targeted scalp botulinum toxin (BTX-A) injections. Methods: Twelve consecutive patients scheduled for presurgical VEM were treated 2–3 weeks before admission with subcutaneous BTX-A injections at specific EEG electrode locations. On the basis of clinical data available before VEM, four subjects were treated unilaterally (group 1) and eight bilaterally (group 2). BTX-A efficacy was assessed quantitatively in group 1 subjects by comparing high-frequency (20–100 Hz) power at homologous “treated” and “untreated” electrodes during voluntary forceful jaw closure. The clinical impact of BTX-A treatment was assessed by determining whether ≥5 of the first 10 s of each ictal recording was obscured by muscle artifact, and whether residual myogenic artifact on BTX-A–“treated” electrodes rendered these ictal EEG segments impossible to interpret. Results: BTX-A treatment reduced high-frequency power by a mean of 53% at electrodes T3/T4 and 52% at electrodes F7/F8. None of 49 ictal EEGs had ≥5 of the first 10 s obscured by myogenic artifact, and all of these ictal epochs were interpretable. Adverse events were limited to two subjects who complained of transient difficulty chewing tough foods. Conclusions: Scalp-muscle BTX-A treatment before VEM significantly reduces myogenic artifact in subsequent EEG recordings, including ictal EEG. The clinical utility of this technique for improved or more-rapid seizure localization will be determined only by large, blinded, prospective trials. [ABSTRACT FROM AUTHOR]
Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Reduction of EEG Myogenic Artifact with Botulinum Toxin during Video-EEG Monitoring.
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  Data: <searchLink fieldCode="AR" term="%22Grant%2C+Arthur+C%2E%22">Grant, Arthur C.</searchLink><br /><searchLink fieldCode="AR" term="%22Hermanowicz%2C+Neal%22">Hermanowicz, Neal</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. Feb2007, Vol. 48 Issue 2, p324-329. 6p. 2 Charts, 3 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Botulinum+toxin%22">Botulinum toxin</searchLink><br /><searchLink fieldCode="DE" term="%22Electroencephalography%22">Electroencephalography</searchLink><br /><searchLink fieldCode="DE" term="%22Injections%22">Injections</searchLink><br /><searchLink fieldCode="DE" term="%22Spasms%22">Spasms</searchLink><br /><searchLink fieldCode="DE" term="%22Myoblasts%22">Myoblasts</searchLink>
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  Data: Purpose: To determine whether EEG myogenic artifact during video-EEG monitoring (VEM) is reduced with targeted scalp botulinum toxin (BTX-A) injections. Methods: Twelve consecutive patients scheduled for presurgical VEM were treated 2–3 weeks before admission with subcutaneous BTX-A injections at specific EEG electrode locations. On the basis of clinical data available before VEM, four subjects were treated unilaterally (group 1) and eight bilaterally (group 2). BTX-A efficacy was assessed quantitatively in group 1 subjects by comparing high-frequency (20–100 Hz) power at homologous “treated” and “untreated” electrodes during voluntary forceful jaw closure. The clinical impact of BTX-A treatment was assessed by determining whether ≥5 of the first 10 s of each ictal recording was obscured by muscle artifact, and whether residual myogenic artifact on BTX-A–“treated” electrodes rendered these ictal EEG segments impossible to interpret. Results: BTX-A treatment reduced high-frequency power by a mean of 53% at electrodes T3/T4 and 52% at electrodes F7/F8. None of 49 ictal EEGs had ≥5 of the first 10 s obscured by myogenic artifact, and all of these ictal epochs were interpretable. Adverse events were limited to two subjects who complained of transient difficulty chewing tough foods. Conclusions: Scalp-muscle BTX-A treatment before VEM significantly reduces myogenic artifact in subsequent EEG recordings, including ictal EEG. The clinical utility of this technique for improved or more-rapid seizure localization will be determined only by large, blinded, prospective trials. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/j.1528-1167.2006.00930.x
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              Text: Feb2007
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