Evidence map›Paper›PMID 40347206›Full record

ArticleEpileptic disorders : international epilepsy journal with videotape2025

Surface-electromyography characteristics of clonic seizures with no scalp-EEG correlate: A comparative analysis with tremors.

Veena V Kumar, Akshaya R Sivaji, Shwetank Singh, Zachary Scicchitano, Brandy Woods, Roohi Katyal, Neel Fotedar

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Epileptic disorders : international epilepsy journal with videotape, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Veena V KumarEpilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
Akshaya R SivajiEpilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
Shwetank SinghEpilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
Zachary ScicchitanoEpilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
Brandy WoodsEpilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
Roohi KatyalDepartment of Neurology, LSU Health Shreveport, Shreveport, Louisiana, USA.
Neel FotedarEpilepsy Center, Neurological Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.ORCID https://orcid.org/0000-0003-0424-7767

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionClonic seizures are characterized by twitching movements at a frequency of 0.2-5 Hz. The clonic "twitch" is produced by a brief synchronized contraction of agonist and antagonist muscles, followed by a synchronized silent period. In this study, we aimed to compare the surface-electromyography (sEMG) characteristics of scalp-EEG negative clonic seizures with those of nonepileptic movements like tremors that can resemble clonic seizures.

methodsWe retrospectively identified patients who were diagnosed with scalp-EEG negative clonic seizures or tremors. We only included patients (n = 6) who were monitored simultaneously with video-EEG and sEMG electrodes. sEMG was placed on agonist and antagonist muscles of the affected extremity using a standardized placement system developed at our institution. We analyzed the following characteristics of sEMG bursts: the relationship between agonist and antagonist muscles and the temporal evolution of burst duration, burst amplitude, and burst frequency.

resultsThe following sEMG characteristics were observed: (i) sEMG bursts and corresponding silent periods were synchronous between agonist and antagonist muscles in clonic seizures. In tremors, an alternating pattern was seen. (ii) sEMG burst amplitude increased during the first 10 s of clonic seizures. There was no significant change in tremors. (iii) sEMG burst duration increased from the beginning to end of clonic seizures. There was no significant change in tremors. (iv) sEMG burst frequency decreased from the beginning to end of clonic seizures due to increased burst and silent period duration. There was no consistent change in burst frequency in tremors. (v) sEMG burst duration of ≥250 ms was indicative of a clonic seizure with a >90% positive predictive value.

conclusionsOur study describes characteristic sEMG features of clonic seizures without scalp-EEG correlates, which can be used as an objective biomarker in distinguishing these from nonepileptic movements such as tremors.

Indexed as

ElectroencephalographyElectromyographySeizuresTremorAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesScalpYoung Adultclonic seizureEEGEtiology: hemorrhage (cerebral)Etiology: idiopathicLocalization: central (right)Localization: not applicablePhenomenology: clonic (non epileptic)Phenomenology: clonic seizuresEMGSyndrome: focal non‐idiopathic parietalSyndrome: non epileptic paroxysmal disordertremor

Identifiers

PMID40347206
PMCPMC12398199

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.