Oct. 27, 2019

I am currently taking Wikipedia + Libraries: Medical and Health Information online course.

This week I am working on a new assignment: Add a reference citation to Wikipedia. I put in brain disease in the search box of the Citation Hunt tool, and found one paragraph from Hashimoto's encephalopathy article.


"Electroencephalogram studies, while almost always abnormal (98% cases), are usually nondiagnostic. The most common findings are diffuse or generalized slowing or frontal intermittent rhythmic delta activity. Prominent triphasic waves, focal slowing, epileptiform abnormalities, photoparoxysmal and photomyogenic responses may be seen.[citation needed]"

I found a possible references:

Hashimoto's Encephalopathy and Seizure Disorders

"Electroencephalography ...EEG is a useful tool in the evaluation of patients suspected of HE. Abnormal EEG results were recorded in 98% of patients with HE (27). Repeated EEG or long-term video EEG increased the positive rate of examination. EEG findings usually show moderate to severe abnormalities, which are often in parallel with clinical improvement after appropriate treatment (34). The EEG abnormalities seen in HE include non-specific diffuse slowing of the background activity (delta or theta frequency wave), interictal epileptiform discharges, repetitive focal spikes or sharps, photomyogenic response, photoparoxysmal response, and generalized biphasic or triphasic waves (35). Diffuse slowing of the background activity is the most common abnormality in HE individuals. The location of epileptic activity is not always consistent with the site of lesions shown on neuroimaging or physical examination (33, 36). Myoclonus seizures were found in about half of the patients with steroid-responsive encephalopathy associated with autoimmune thyroiditis in one study (36). None of these EEG findings were specific for the diagnosis of HE and can be seen in encephalopathy due to other causes. Because of the non-specificity of the EEG examination, it seems to be a limited tool in differential diagnosis of seizure disorders and/or encephalopathy with other possible causes of encephalopathy (37). However, EEG is helpful in reflecting changes in brain functions during hospitalization and follow-up."

I also found many articles from NIH with similar information. However most articles found in NIH combine case study with literature review. I am not sure whether these references can be considered as reliable and NOP since they include individual studies. Then I got a warning about predatory publishing when I tried to add Frontier.org as a reference. Then I found the same article at ncbi.nih.nim.gov website. I changed the source to this site and I didn't get any warning. I am confused.