Watemberg Nathan, Gandelman Revital, Neufeld Miri Y, Ginsberg Mira, Lerman-Sagie Tally, Kramer Uri
Pediatric Neurology Unit, Wolfson Medical Center, Holon, Israel.
J Child Neurol. 2003 Aug;18(8):525-9. doi: 10.1177/08830738030180080601.
Frontal intermittent rhythmic delta activity is an electrographic pattern of unclear origin. Previously thought to correlate with deep midline and infratentorial pathology, rather, it appears to be associated with encephalopathy states in adults. The significance of frontal intermittent rhythmic delta activity in children has not been studied. We analyzed the electrographic characteristics and clinical associations of pediatric frontal intermittent rhythmic delta activity. This pattern was rarely detected, occurring in 20 of 1500 electroencephalographic (EEG) studies. Patients' ages ranged between 1.5 and 17 years. Most patients were awake and showed no signs of acute encephalopathy when frontal intermittent rhythmic delta activity occurred. Half of the children were cognitively impaired, and half had a history of epilepsy. Epileptiform activity was present in 55% of the EEG recordings. However, frontal intermittent rhythmic delta activity was part of the epileptiform discharge in only a minority of cases. The duration of frontal intermittent rhythmic delta activity bursts was longer in the mentally retarded group. Most patients did not have structural brain pathology. None had deep midline or infratentorial lesions. In conclusion, frontal intermittent rhythmic delta activity is rare in children, is not associated with acute encephalopathy or with deep midline or infratentorial lesions, and tends to occur during wakefulness. The electrographic characteristics of frontal intermittent rhythmic delta activity appear to differ between cognitively normal and mentally retarded children.
额部间歇性节律性δ活动是一种起源不明的脑电图模式。以前认为它与深部中线及幕下病变相关，相反，它似乎与成人的脑病状态有关。儿童额部间歇性节律性δ活动的意义尚未得到研究。我们分析了儿童额部间歇性节律性δ活动的脑电图特征及临床相关性。这种模式很少被检测到，在1500份脑电图（EEG）研究中有20份出现。患者年龄在1.5岁至17岁之间。当额部间歇性节律性δ活动出现时，大多数患者是清醒的，且没有急性脑病的迹象。一半的儿童存在认知障碍，一半有癫痫病史。55%的脑电图记录中有癫痫样活动。然而，额部间歇性节律性δ活动仅在少数病例中是癫痫样放电的一部分。智力发育迟缓组中额部间歇性节律性δ活动爆发的持续时间更长。大多数患者没有脑结构病变。没有人有深部中线或幕下病变。总之，额部间歇性节律性δ活动在儿童中罕见，与急性脑病或深部中线及幕下病变无关，且倾向于在清醒时出现。认知正常儿童和智力发育迟缓儿童的额部间歇性节律性δ活动脑电图特征似乎有所不同。
