Joseph Perumpillichira

The waveman, addicted to EEG signals

[Joseph Perumpillichira @JosephCPerum]

@AMoosaMD @CLENeurons @CleClinicMD @CleClinicKids Well done Moosa. Congratulations 👏

[Joseph Perumpillichira @JosephCPerum]

@convectuoso111 @NeuroPBL @theABN_Info Well done

[Joseph Perumpillichira @JosephCPerum]

@KatyCDodd Congratulations

[Joseph Perumpillichira @JosephCPerum]

@rajeshramnair Congratulations Rajesh

[Joseph Perumpillichira @JosephCPerum]

@KatyCDodd @BSI_neuroimmune Well done Katy👏

[Joseph Perumpillichira @JosephCPerum]

Can studying IEDs following 50 Hz cortical stimulation help in identifying SOZ. Dr Ana Suler Marti @aes 2023 Orlando

[Joseph Perumpillichira @JosephCPerum]

Utility of exploring thalamic nucleoid during Stereo EEG studies by Ryan McGinn and colleagues from Stanford. AES 2023 Orlando

[Joseph Perumpillichira @JosephCPerum]

@AlexandraUrban_ @PittEpilepsy @RamadhaniRuba Management of uremic encephalopathy, including Hemodialysis

[Joseph Perumpillichira @JosephCPerum]

@vumcpedepilepsy Arousal/state change at 7 sec on Fig 1. The rhythmic bilat F delta in Fig 2 is likely to be an artifact

[Joseph Perumpillichira @JosephCPerum]

@PianoMedic Great experience, on the Hornblower

[Joseph Perumpillichira @JosephCPerum]

@vumcpedepilepsy Childhood Occipital Visual Epilepsy (COVE), a self limited focal Epilepsy of childhood (previously known as idiopathic childhood Epilepsy -Gastaut). EEG shows high amplitude Occipital spike-wave, L>R

[Joseph Perumpillichira @JosephCPerum]

@vumcpedepilepsy Fixation- off sensitivity seen on eye closure, as well as increased activation of trains of bilateral occipital sharp waves during HV

[Joseph Perumpillichira @JosephCPerum]

@vumcpedepilepsy sorry, involving both Fp1 and Fp2 electrodes

[Joseph Perumpillichira @JosephCPerum]

@vumcpedepilepsy Likely Fp2 electrode artifacts . The EEG background activity is markedly abnormal, showing a persistent low voltage pattern

[Joseph Perumpillichira @JosephCPerum]

@vumcpedepilepsy 6 and 14 Hz positive spikes, benign EEG variant in drowsiness and light sleep

[Joseph Perumpillichira @JosephCPerum]

@vumcpedepilepsy GPFA (12-14 Hz generalized paroxysmal fast activity) in sleep. It has been described in Lennox Gastaut syndrome, as well as in other generalized epilepsies. Polygraphy using deltoid, trapezius surface EMG electrodes, might sometimes correlate this with subtle tonic seizures

[Joseph Perumpillichira @JosephCPerum]

@vumcpedepilepsy Near continuous generalized, frontally dominant slow (2 Hz) SW discharges, with persistent higher amplitude L, clinically manifesting as atypical absences (correct usage is "prolonged focal unaware seizures" and NCSE). Maybe worthwhile working up for resective epilepsy surgery

[Joseph Perumpillichira @JosephCPerum]

@vumcpedepilepsy Lambda waves , normal physiological waves. These are bilateral occipital, triangular shaped waveforms, with positive polarity, seen during visually scanning a picture or watching a video

[Joseph Perumpillichira @JosephCPerum]

@vumcpedepilepsy Early myoclonic encephalopathy is likely, (if there's no h/o asphyxia or HIE), indicates poor neurol prognosis. Differentials of EME are broad, including metabolic(NKH, pyridoxine dependency etc) & genetic (SCN, CDKL5, GABR). Accurate diagnosis guides Rx and prognosis