Watemberg Nathan, Alehan Fusun, Dabby Ron, Lerman-Sagie Tally, Pavot Pierre, Towne Alan
Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel.
J Clin Neurophysiol. 2002 Dec;19(6):535-9. doi: 10.1097/00004691-200212000-00006.
To assess the clinical and radiologic correlates of frontal intermittent rhythmic delta activity (FIRDA), the authors reviewed the hospital charts of patients whose EEGs depicted this EEG finding, and recorded their past medical and neurologic history, the reason for hospital admission, and their neurologic status both on admission and during EEG recordings. Laboratory results on admission and concomitant to the EEG recording, computed tomography, or MRI findings during hospital admission were also reviewed. Sixty-eight patients were assessed. The gender ratio was 1:1; mean age was 56 years. Chronic disease occurred in 78% of patients, including hypertension (34%), diabetes (32%), and renal failure (18%). On admission, renal failure (n = 34) and hyperglycemia (n = 22) were most prominent. The majority of patients had at least one abnormal laboratory result. Thirty-eight of 51 patients in whom the level of consciousness was stated during EEG were described as awake. More than half of 58 patients whose EEG background activity was stipulated demonstrated diffuse slowing, mostly in the theta range. MRI was abnormal in 15 of 17 patients. Intrahemispheric lesions, particularly ischemic and hemorrhagic, were most common (n = 10), followed by basal ganglia lacunae (n = 4). Computed tomography was abnormal in 29 of 44 patients. Hemispheric pathology, diffuse or localized, occurred in 22 patients. Frontal intermittent rhythmic delta activity is associated with mild to moderate encephalopathy and is detected principally in awake patients. Most patients in this series had chronic systemic illness. Old ischemic structural brain lesions may predispose some patients to develop FIRDA during acute metabolic derangement, such as uremia and hyperglycemia. Frontal intermittent rhythmic delta activity was not associated with EEG epileptiform activity. Deep midline lesions, posterior fossa tumors, and hydrocephalus were not detected in this series of patients with FIRDA.
为评估额叶间歇性节律性δ活动（FIRDA）的临床和影像学相关性，作者回顾了脑电图显示该脑电图表现的患者的医院病历，并记录了他们过去的内科和神经科病史、入院原因以及入院时和脑电图记录期间的神经科状况。还回顾了入院时及脑电图记录同时的实验室检查结果、住院期间的计算机断层扫描或磁共振成像（MRI）结果。共评估了68例患者。男女比例为1:1；平均年龄为56岁。78%的患者患有慢性病，包括高血压（34%）、糖尿病（32%）和肾衰竭（18%）。入院时，肾衰竭（n = 34）和高血糖（n = 22）最为突出。大多数患者至少有一项异常实验室检查结果。在脑电图检查时记录了意识水平的51例患者中，38例被描述为清醒。在58例规定了脑电图背景活动的患者中，超过一半表现为弥漫性减慢，主要在θ波范围。17例患者中有15例MRI异常。半球内病变，尤其是缺血性和出血性病变最为常见（n = 10），其次是基底节腔隙性梗死（n = 4）。44例患者中有29例计算机断层扫描异常。22例患者出现半球性病变，可为弥漫性或局限性。额叶间歇性节律性δ活动与轻至中度脑病相关，主要在清醒患者中检测到。本系列中的大多数患者患有慢性全身性疾病。陈旧性缺血性脑结构性病变可能使一些患者在急性代谢紊乱（如尿毒症和高血糖）期间易发生FIRDA。额叶间歇性节律性δ活动与脑电图癫痫样活动无关。在这组FIRDA患者中未检测到深部中线病变、后颅窝肿瘤和脑积水。
