Siepman T A M, Cherian P Joseph, Visser G H
Department of Clinical Neurophysiology, Erasmus MC, Rotterdam, The Netherlands.
Am J Electroneurodiagnostic Technol. 2004 Mar;44(1):24-9.
We report two patients with acute cerebral conditions and zeta waves on their EEGs. The first patient, a 48-year-old lady, had acute disseminated encephalomyelitis (ADEM)following afebrile illness. Neurological examination showed expressive dysphasia and a mild right hemiparesis. The magnetic resonance imaging (MRI) scan of the brain showed multiple, bilateral, subcortical white matter hyperintensities, predominantly in the centrum semiovale region of the left hemisphere, and also in the corpus callosum. An EEG done 21 days after the onset of the neurological deficit showed intermittent, sharply contoured, predominantly biphasic delta waves (zeta waves) over the left frontotemporal region. The second patient was a 2-year-old child, who had a head-injury resulting in bilateral, frontoparietal fractures of the skull; acute epidural hematoma on the left frontoparietal region; and a cerebral contusion on the right frontotemporal region. An EEG done one day after the evacuation of the hematoma showed zeta waves over the right frontal region. To the best of our knowledge, the association of zeta waves and ADEM has not been previously reported. The EEG findings in our patients again supports the hypothesis that these waves are seen predominantly in patients with structural brain lesions. Other conditions causing zeta waves in the EEG are briefly reviewed.
我们报告了两名患有急性脑部疾病且脑电图出现ζ波的患者。第一名患者是一位48岁女性，在无热疾病后发生急性播散性脑脊髓炎（ADEM）。神经系统检查显示表达性失语和轻度右侧偏瘫。脑部磁共振成像（MRI）扫描显示双侧皮质下多发白质高信号，主要位于左半球半卵圆中心区域，胼胝体也有。在神经功能缺损发作21天后进行的脑电图显示左额颞区出现间歇性、轮廓清晰、主要为双相的δ波（ζ波）。第二名患者是一名2岁儿童，头部受伤导致双侧额顶颅骨骨折；左额顶区急性硬膜外血肿；右额颞区脑挫伤。血肿清除一天后进行的脑电图显示右额区出现ζ波。据我们所知，ζ波与ADEM的关联此前尚未有报道。我们患者的脑电图结果再次支持了这样的假说，即这些波主要出现在有脑部结构性病变的患者中。文中简要回顾了脑电图中导致ζ波的其他情况。
