Cortico-cortical evoked potential (CCEP) mapping is a rapidly developing method for visualizing the brain network and estimating cortical excitability. The CCEP comprises the early N1 component the occurs at 10-30 ms poststimulation, indicating anatomic connectivity, and the late N2 component that appears at < 200 ms poststimulation, suggesting long-lasting effective connectivity. A later component at 200-1,000 ms poststimulation can also appear as a delayed response in some studied areas. Such delayed responses occur in areas with changed excitability, such as an epileptogenic zone. CCEP mapping has been used to examine the brain connections causally in functional systems such as the language, auditory, and visual systems as well as in anatomic regions including the frontoparietal neocortices and hippocampal limbic areas. Task-based CCEPs can be used to measure behavior. In addition to evaluations of the brain connectome, single-pulse electrical stimulation (SPES) can reflect cortical excitability, and so it could be used to predict a seizure onset zone. CCEP brain mapping and SPES investigations could be applied both extraoperatively and intraoperatively. These underused electrophysiologic tools in basic and clinical neuroscience might be powerful methods for providing insight into measures of brain connectivity and dynamics. Analyses of CCEPs might enable us to identify causal relationships between brain areas during cortical processing, and to develop a new paradigm of effective therapeutic neuromodulation in the future.

Citations

• The impact of radiofrequency thermocoagulation on brain connectivity in drug‐resistant epilepsy: Insights from stereo‐electroencephalography and cortico‐cortical evoked potentials
  Justyna Gula, Rutger J. Slegers, Raf H. M. Van Hoof, Balu Krishnan, Massimo Mischi, Vivianne H. J. M. van Kranen‐Mastenbroek, Ilse E. C. W. Van Straaten, Danny Hilkman, Louis Wagner, Albert Colon, Olaf E. M. G. Schijns, Borbála Hunyadi, Jacobus F. A. Jans
  Epilepsia.2025; 66(4): 1260.     CrossRef
• Recent developments in stereo electroencephalography monitoring for epilepsy surgery
  Debopam Samanta
  Epilepsy & Behavior.2022; 135: 108914.     CrossRef

Carotid duplex ultrasound is commonly used to diagnose various carotid artery diseases due to it being noninvasive and easy to perform. Carotid atherosclerosis is a major indicator for the need to perform carotid duplex ultrasound, which can determine the degree of stenosis, plaque characteristics, and intima-media thickness. It can also be used to screen and follow-up after carotid revascularization. Here we discuss the standard techniques, interpretations, and clinical indicators for carotid duplex ultrasounds.

Citations

• The diagnosis and treatment of asymptomatic and symptomatic patients with carotid artery stenosis
  Robert J. Henning, Brian L. Hoh
  Current Problems in Cardiology.2025; 50(6): 102992.     CrossRef
• Symptomatic Cervical Carotid Artery Stenosis: Evolving Paradigms in Risk Stratification and Intervention
  Ivy Anne Sebastian, Kazbek Barakhanov, Aravind Ganesh
  Annals of Indian Academy of Neurology.2025; 28(1): 1.     CrossRef
• Eagle Syndrome: Case Report, Literature Review, Proposed Classification, and Role of Ultrasound in its Diagnosis and Management
  David M. Williams, Elizabeth M. Wooster, Charles E. Stonerock, Douglas L. Wooster
  Journal for Vascular Ultrasound.2024; 48(4): 225.     CrossRef
• Ultrasound Score of Liver Steatosis Severity in the Diagnosis of Peripheral Arterial Atherosclerosis in Patients with Nonalcoholic Fatty Liver Disease
  A. S. Kuznetsova, A. I. Dolgushina, V. V. Pospelov, T. A. Sokolova, E. V. Lebedev, V. V. Genkel
  The Russian Archives of Internal Medicine.2023; 13(3): 196.     CrossRef
• The Use of Ultrasound for Detecting the Association Between Endothelial Dysfunction and lp13.3 Genomic Region rs646776 Polymorphism in Patients With Rheumatoid Arthritis From the Suez Canal Region
  Afaf Ahmed, Aziza Omar, Maivel Ghattas, Mona Ghaly, Mohammad al-Shatouri
  Cureus.2023;[Epub]     CrossRef
• Diagnostic Efficacy of Advanced Ultrasonography Imaging Techniques in Infants with Biliary Atresia (BA): A Systematic Review and Meta-Analysis
  Simon Takadiyi Gunda, Nonhlanhla Chambara, Xiangyan Fiona Chen, Marco Yiu Chung Pang, Michael Tin-cheung Ying
  Children.2022; 9(11): 1676.     CrossRef

A brain-computer interface (BCI) is a technology that acquires and analyzes electrical signals from the brain to control external devices. BCI technologies can generally be used to control a computer cursor, limb orthosis, or word processing. This technology can also be used as a neurological rehabilitation tool for people with poor motor control. We reviewed historical attempts and methods toward predicting arm movements using brain waves. In addition, representative studies of minimally invasive and noninvasive BCI were summarized.

Citations

• Dynamic decision-making framework for benchmarking brain–computer interface applications: a fuzzy-weighted zero-inconsistency method for consistent weights and VIKOR for stable rank
  Z. T. Al-qaysi, A. S. Albahri, M. A. Ahmed, Mahmood M. Salih
  Neural Computing and Applications.2024; 36(17): 10355.     CrossRef

Background
Pain and autonomic dysfunction are prominent symptoms in some patients with carpal tunnel syndrome (CTS). Infrared thermography (IRT) has been used to evaluate CTS by measuring the cutaneous temperature and sympathetic vasomotor function.
Methods
This study enrolled the 66 hands of 33 subjects, some of which had clinical CTS and the others were healthy. The enrolled patients completed the Boston Carpal Tunnel Questionnaire (BCTQ) and Historical-Objective scale, and underwent nerve conduction studies (NCSs) and IRT. Skin temperature was measured at the fingertips and the thenar and hypothenar regions in each hand. We analyzed (1) the correlations between self-reported severity, physician-assessed severity, and test results, and (2) the sensitivity and specificity of IRT in diagnosing CTS.
Results
No significant correlation was observed between the results of the BCTQ, NCS, and IRT. IRT had a low sensitivity and high specificity in diagnosing CTS.
Conclusions
IRT cannot replace NCS in diagnosing CTS, nor did it provide an advantage in combination with NCS. However, lower temperatures at the median nerve in some hands with moderate-to-severe CTS suggested the involvement of sympathetic nerve fiber function. Follow-up studies with a larger-scale and complementary design are required to elucidate the relationships.

Citations

• Infrared medical thermography, medical applications, and its basic principles: A review
  Ali Faisal Abdulkareem, Auns Qusai Hashim, N. Aldahan, A.J. Ramadhan
  BIO Web of Conferences.2024; 97: 00140.     CrossRef

Background
Nitrous oxide (N₂O) is used in surgery and dentistry for its anesthetic and analgesic effects. However, neurological and psychiatric manifestations of N₂O abuse have been increasingly reported among Korean adults. The aim of this study was to demonstrate laboratory findings of N₂O abuse in Korean patients.
Methods
Patients diagnosed with N₂O-induced neuropathy or myelopathy from August 2018 to December 2019 were enrolled. Their clinical presentations and laboratory and imaging findings were analyzed.
Results
Sensory changes and limb weakness were present in nine of the enrolled patients. The laboratory findings revealed that seven patients had high homocysteine levels and five had high methylmalonic acid levels in their blood. Nerve conductions studies indicated that axonal neuropathy was present in four cases and longer F-wave and Hoffman’s-reflex latencies were present in two cases. Signal changes in cervical spine imaging occurred in five patients, while two had normal results.
Conclusions
Chronic N₂O abuse can cause neurological damage or psychiatric problems. Because N₂O is illegal for recreational use in Korea, patients tend to hide their history of use. Even though the spinal imaging results were normal, clinicians should consider the possibility of N₂O use, and further electrophysiological tests should be applied for precise evaluations.

Citations

• The prevalence, risks, and detection of driving under the influence of nitrous oxide
  Frederick R. J. Vinckenbosch, Dinesh Durán Jiménez, Hendrik Helmerhorst, Albert Dahan, Leon Aarts, Floris Bikker, Eef Theunissen, Johannes G. Ramaekers
  WIREs Forensic Science.2024;[Epub]     CrossRef
• Nitrous‐oxide‐induced polyneuropathy and subacute combined degeneration of the spine: clinical and diagnostic characteristics in 70 patients, with focus on electrodiagnostic studies
  L. T. Hassing, F. Y. Jiang, R. Zutt, S. Arends
  European Journal of Neurology.2024;[Epub]     CrossRef
• Severe Isolated Peripheral Polyneuropathy without Myelopathy after Nitrous Oxide Abuse: A Case Report
  Seung-Min Baek, Seungbok Lee, Yu-Mi Kim, Eun-Sil Kim
  Journal of Electrodiagnosis and Neuromuscular Dise.2022; 24(2): 50.     CrossRef

Tetanus is an infectious disease of the nervous system caused by Clostridium tetani, and is characterized by tonic muscle contractions, painful spasms, and autonomic dysfunction. Severe autonomic dysfunction associated with tetanus can be life-threatening. We present a 62-year-old female who experienced lockjaw after an ankle fracture. The patient was diagnosed with tetanus and received tetanus immunoglobulin and a vaccination. The patient subsequently experienced labile hypertension. This case highlights the challenge and importance of managing cardiovascular instability.

Citations

• Successful management of severe generalized tetanus in a 23‐year man with phenobarbital adjuvant: A case report
  Arezoo Ahmadi, Elahe Karimpour‐Razkenari, Ramin Ansari, Mahforouzalsadat Marashi, Hamidreza Sharifnia, Atabak Najafi, Mojtaba Mojtahedzadeh
  Clinical Case Reports.2023;[Epub]     CrossRef

Bell’s palsy is an acute peripheral facial paralysis with no detectable cause. Although the prognosis of Bell’s palsy is generally good, some patients experience poor recoveries and there is no established treatment for those that do not recover even after receiving the conventional treatment. Here we present two cases of refractory Bell’s palsy with facial nerve enhancement in magnetic resonance imaging who showed symptomatic improvement after the late administration of high-dose intravenous methylprednisolone.

Citations

• Development of the Korean Medicine Core Outcome Set for Facial Palsy: herbal medicine treatment of patients with facial palsy in primary clinics
  Soo-Dam Kim, Sungha Kim, Mi Ju Son, Jiyun Cha, Pyung-Wha Kim, Mi Mi Ko, Soobin Jang, Changsop Yang, Myeong Soo Lee
  Frontiers in Medicine.2024;[Epub]     CrossRef

We present a patient with a primitive neuroectodermal tumor arising from the right atrium who experienced multiple syncope episodes daily, which had first appeared 1 month after surgery. The symptoms continued to worsen over the course of chemotherapy, and the autonomic function test (AFT) was performed after the 14th chemotherapy cycle. The AFT revealed orthostatic hypotension and reduced baroreflex-dependent sympathetic reactivity. Physical counterpressure techniques were applied with a visual biofeedback intervention, and were found to be effective in reducing the syncope episodes.

X-linked Charcot Marie Tooth disease type 1 (CMTX1) is a clinically heterogenous X-linked hereditary neuropathy caused by mutation of the gene encoding gap junction beta 1 protein (GJB1). Typical clinical manifestations of CMTX1 are progressive weakness or sensory disturbance due to peripheral neuropathy. However, there have been some CMTX1 cases with accompanying central nervous system (CNS) manifestations. We report the case of a genetically confirmed CMTX1 patient who presented recurrent transient CNS symptoms without any symptom or sign of peripheral nervous system involvement.

Primary hyperparathyroidism (PHP) is a disease in which excessive amounts of parathyroid hormone (PTH) are secreted and calcium levels in the blood increase. Hypercalcemia caused by PHP has a major influence on the peripheral nervous system and produces symptoms such as muscle cramps, paresthesia, and proximal muscle weakness. Here we report a rare case of sensory-dominant polyneuropathy caused by PHP, which improved after surgery.