Proposal for electroencephalogram standardization in aircrew selection

Social aspects of life in patients with functional seizures: Closing the gap in the biopsychosocial formulation

The human, as a biological system, is an open system embedded within larger systems -including the family, culture, and socio-political environment. In this context, a patient with functional seizures (FS) is embedded in relationships, educational/professional institutions, culture, and society. Both connection to these broader systems and the quality of these connections, as well as the soundness of each system in and of itself, influence the health and well-being of patients in positive or negative ways. The social aspects of life are important determinants of health and quality of life across the lifespan. The current narrative review brings out several overarching themes in patients with FS. Sections on attachment, marriage, social networking, and stigma highlight the central roles of supportive and affirmative relationships across the lifespan. The section on education underscores the importance of keeping children and youth with FS connected within their school environments, as well as managing any barriers - learning difficulties, school response to FS events, stigma, etc.-that can diminish this connection. Finally, the sections on employment and driving highlight the value of being an active participant in one's society. In summary, FS impacts patients across most social aspects of life domains regardless of age - factors that are important when developing biopsychosocial formulations. This review concludes that the multidisciplinary management of FS requires careful assessment of social aspects of life in patients which can then be targeted for treatment, to improve their quality of life, facilitating recovery, and reducing the risk of relapse.

Electroencephalographic Abnormalities in the Screening for Pilot Applicants in Korea

Background and Purpose

Electroencephalography (EEG) is often used as a screening tool for selecting pilots despite controversy regarding its contribution to aviation safety. We investigated EEG abnormalities in Korean commercial pilot applicants in order to identify the usefulness of EEG screening in this population.

Methods

We retrospectively analyzed the EEG results of 740 unselected pilot applicants who underwent waking EEG at Inha University Hospital from January 2013 to May 2017. EEG recording was performed for 30 minutes, which included 3 minutes of hyperventilation and intermittent photic stimulation.

Results

The pilot applicants were predominantly male (95.3%) and had a mean age of 27.8 years (range: 16–40 years). Nine of them (1.2%) exhibited EEG abnormalities; the most common abnormality (six applicants) was a small amount of generalized irregular slow activities, while the other three applicants (0.4%) exhibited epileptiform discharges, with two showing generalized spike-and-wave complexes and one showing a few spike-and-wave complexes in the left frontotemporal area. The two applicants with generalized spike-and-wave complexes were found to have experienced clinical seizures by a neurologist during detailed history-taking.

Conclusions

This study found that 2 of 740 pilot applicants (0.3%) were diagnosed with epilepsy by routine EEG screening in an unselected population. Considering the low predictive value of EEG without the relevant clinical history in an unselected healthy young population, our findings raise questions regarding the cost-effectiveness of the current EEG screening protocol applied to pilot applicants. We suggest that a more-targeted and standardized EEG screening approach be applied to pilot applicants with epilepsy risk factors or a seizure history as determined by thorough medical history-taking.

Electroencephalographic recordings of physiological activity of the sheep cerebral cortex

This paper presents the physiological activity of the cerebral cortex in sheep in electroencephalo- graphic findings. The study was performed to evaluate and improve understanding of brain monitor- ing methods in freely moving animals without the use of any anaesthetic methods during the acquisi- tion stage. The aim of the study was to determine the physiological activity of the cerebral cortex in animals in a sheep model (using clinically healthy Polish Merino rams, aged 1 yr.) to determine its clinical EEG protocol. The EEG was registered using an in-lab EEG device as well as ambulatory systems (Holter EEG). The bioelectrical activity of the sheep cerebral cortex was recorded using gold disc and needle electrodes placed on experimentally determined locations on the scalp. The main finding of this study was the rhythmic EEG activity of the sheep brain in wakeful and conscious states (eyes open). The rhythm was bilaterally synchronous and determined a basic pattern in the registra- tion of physiological activity of the cerebral cortex. The acquired rhythm may correspond to the theta rhythm in humans, which is a normal activity controlled by the hippocampus. This background activity comprised intermittent episodic slow waves and synchronous beta waves.