Simultaneous recording of EEG and electromyographic polygraphy increases the diagnostic yield of video-EEG monitoring

Myoclonus: Differential diagnosis and current management

Myoclonus classically presents as a brief (10-50 ms duration), non-rhythmic jerk movement. The etiology could vary considerably ranging from self-limited to chronic or even progressive disorders, the latter falling into encephalopathic pictures that need a prompt diagnosis. Beyond the etiological classification, others evaluate myoclonus' body distribution (i.e., clinical classification) or the location of the generator (i.e., neurophysiological classification); particularly, knowing the anatomical source of myoclonus gives inputs on the observable clinical patterns, such as EMG bursts duration or EEG correlate, and guides the therapeutic choices. Among all the chronic disorders, myoclonus often presents itself as a manifestation of epilepsy. In this context, myoclonus has many facets. Myoclonus occurs as one, or the only, seizure manifestation while it can also present as a peculiar type of movement disorder; moreover, its electroclinical features within specific genetically determined epileptic syndromes have seldom been investigated. In this review, following a meeting of recognized experts, we provide an up-to-date overview of the neurophysiology and nosology surrounding myoclonus. Through the dedicated exploration of epileptic syndromes, coupled with pragmatic guidance, we aim to furnish clinicians and researchers alike with practical advice for heightened diagnostic management and refined treatment strategies. PLAIN LANGUAGE SUMMARY: In this work, we described myoclonus, a movement characterized by brief, shock-like jerks. Myoclonus could be present in different diseases and its correct diagnosis helps treatment.

Rational manipulation of digital EEG: pearls and pitfalls

The advent of digital EEG has provided greater flexibility and more opportunities in data analysis to optimize the diagnostic yield. Changing the filter settings, sensitivity, montages, and time-base are possible rational manipulations to achieve this goal. The options to use polygraphy, video, and quantification are additional useful features. Aliasing and loss of data are potential pitfalls in the use of digital EEG. This review illustrates some common clinical scenarios where rational manipulations can enhance the diagnostic EEG yield and potential pitfalls in the process.