Occipital Intermittent Rhythmic Delta Activity (OIRDA) In Pediatric Focal Epilepsies: A Case Series

Introduction Lateralized rhythmic delta activity (LRDA) is a rare pattern on the ictal-interictal continuum (IIC) encountered in critically ill patients. Its association with acute seizures is yet to be fully explored. Insular involvement is a common finding in patients with infectious and autoimmune encephalitis. The association between acute insular lesions and the ictal-interictal continuum, particularly LRDA, has not been explored before. Methods A case series of 4 patients with either herpetic or autoimmune encephalitis and prominent insular cortex involvement who had LRDA when monitored on continuous EEG is being presented. Results Two patients had herpetic encephalitis and 2 patients had autoimmune encephalitis. All patients had either clinical or electrographic seizures with 1 patient progressing into new-onset refractory status epilepticus. Conclusion LRDA can be seen in patients with insular cortex acute inflammation. In this group of patients, LRDA may be associated with a higher risk of acute seizures. The presence of this otherwise not clearly epileptiform pattern should raise the clinical suspicion for the development of acute seizures. Patients with LRDA and ipsilateral insular lesions should be carefully monitored for the development of recurrent electrographic or electroclinical seizures and status epilepticus.

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Generalized Rhythmic Delta Activity Frontally Predominant Differentiates Dementia With Lewy Bodies From Alzheimer's Disease and Parkinson's Disease Dementia: A Conventional Electroencephalography Visual Analysis

Clinical EEG and Neuroscience ◽

10.1177/1550059421997147 ◽

2021 ◽

pp. 155005942199714

Author(s):

Lucia Zinno ◽

Anna Negrotti ◽

Chiara Falzoi ◽

Giovanni Messa ◽

Matteo Goldoni ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Parkinson’S Disease ◽

Alzheimer's Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Dementia With Lewy Bodies ◽

Visual Analysis ◽

Lewy Bodies ◽

Delta Activity ◽

Rhythmic Delta Activity

Introduction. An easily accessible and inexpensive neurophysiological technique such as conventional electroencephalography may provide an accurate and generally applicable biomarker capable of differentiating dementia with Lewy bodies (DLB) from Alzheimer’s disease (AD) and Parkinson’s disease-associated dementia (PDD). Method. We carried out a retrospective visual analysis of resting-state electroencephalography (EEG) recording of 22 patients with a clinical diagnosis of 19 probable and 3 possible DLB, 22 patients with probable AD and 21 with PDD, matched for age, duration, and severity of cognitive impairment. Results. By using the grand total EEG scoring method, the total score and generalized rhythmic delta activity frontally predominant (GRDAfp) alone or, even better, coupled with a slowing of frequency of background activity (FBA) and its reduced reactivity differentiated DLB from AD at an individual level with an high accuracy similar to that obtained with quantitative EEG (qEEG). GRDAfp alone could also differentiate DLB from PDD with a similar level of diagnostic accuracy. AD differed from PDD only for a slowing of FBA. The duration and severity of cognitive impairment did not differ between DLB patients with and without GRDAfp, indicating that this abnormal EEG pattern should not be regarded as a disease progression marker. Conclusions. The findings of this investigation revalorize the role of conventional EEG in the diagnostic workup of degenerative dementias suggesting the potential inclusion of GRDAfp alone or better coupled with the slowing of FBA and its reduced reactivity, in the list of supportive diagnostic biomarkers of DLB.

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BOLD-contrast functional MRI signal changes related to intermittent rhythmic delta activity in EEG during voluntary hyperventilation—simultaneous EEG and fMRI study

NeuroImage ◽

10.1016/j.neuroimage.2004.01.004 ◽

2004 ◽

Vol 22 (1) ◽

pp. 222-231 ◽

Cited By ~ 20

Author(s):

Minna J. Mäkiranta ◽

Jyrki Ruohonen ◽

Kalervo Suominen ◽

Eila Sonkajärvi ◽

Timo Salomäki ◽

...

Keyword(s):

Functional Mri ◽

Voluntary Hyperventilation ◽

Fmri Study ◽

Delta Activity ◽

Signal Changes ◽

Rhythmic Delta Activity

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De novo temporal intermittent rhythmic delta activity after laser interstitial thermal therapy for mesial temporal lobe epilepsy predicts poor seizure outcome

Clinical Neurophysiology ◽

10.1016/j.clinph.2018.11.012 ◽

2019 ◽

Vol 130 (1) ◽

pp. 122-127 ◽

Cited By ~ 3

Author(s):

William O. Tatum ◽

Neeharika Thottempudi ◽

Vivek Gupta ◽

Anteneh M. Feyissa ◽

Sanjeet S. Grewal ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

De Novo ◽

Mesial Temporal Lobe Epilepsy ◽

Thermal Therapy ◽

Seizure Outcome ◽

Laser Interstitial Thermal Therapy ◽

Delta Activity ◽

Mesial Temporal Lobe ◽

Rhythmic Delta Activity

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EEG in genetic generalized epilepsies

Epilepsia and paroxyzmal conditions ◽

10.17749/2077-8333.2020.12.1s.s23-s40 ◽

2020 ◽

Vol 12 (1S) ◽

pp. 23-40

Author(s):

V. Yu. Nogovitsyn ◽

A. A. Sharkov

Keyword(s):

Differential Diagnosis ◽

Juvenile Myoclonic Epilepsy ◽

Absence Epilepsy ◽

Night Time ◽

Epileptiform Discharges ◽

Atypical Features ◽

Delta Activity ◽

Ictal Activity ◽

Rhythmic Delta Activity ◽

Generalized Epilepsy

Genetic, or idiopathic, generalized epilepsies (GGEs or IGEs) includes childhood absence epilepsy (CAE), juvenile absence epilepsy (JAE), juvenile myoclonic epilepsy (JME), and epilepsy with generalized tonic-clonic seizures alone (GTCS-a).Aim. to characterize the capabilities of electroencephalography (EEG) for the diagnosis of various forms of genetic generalized epilepsyMaterials and methods. Literature data in Pubmed, Google Scholar was analyzed. In addition, own observations and clinical cases were systematized.Results. The article presents the data of morphology and topography of spike-wave discharges, as well as other patterns of EEG in the GGE – poly-spike activity, photoparoxysmal response, occipital intermittent rhythmic delta activity (OIRDA), fixation-off sensitivity and generalized paroxysmal fast activity (GPFA), as well as epileptiform K-complexes, the allocation of which in an independent pattern is questioned by a number of neurophysiologists. The differences between interictal and ictal activity in the GGE are discussed in detail; electroencephalogram (EEG) informativity modifiers are considered. The morphology of atypical features in the GGE is considered. The role of EEG in the differential diagnosis of CAE, JAE, JME, GTCS alone with the description of typical, atypical features, study scenarios and diagnostic criteria for each form are considered.Conclusions. Typical EEG features of GGE significantly simplify the differential diagnosis of electroclinical syndromes. There are “non-classical” features of EEG in the GGE, which do not contradict the diagnosis. To reveal the peculiarities of epileptiform discharges distribution, video EEG monitoring with night-time sleep and the use of several modality stimuli is preferable. Incorrect interpretation of EEG is dangerous for the patient.

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