Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
J Clin Neurophysiol. 2013 Jun;30(3):255-60. doi: 10.1097/WNP.0b013e3182933d4d.
Subclinical rhythmic electrographic discharge of adults (SREDA) is the rarest benign epileptiform variant. It is an established EEG phenomenon that when present may cause confusion with an epileptic discharge for those unfamiliar with the entity. An electronic term search was performed on all EEG reports to identify those records reported as showing SREDA and other benign variants. Serial EEG reports of 5,200 subjects who underwent EEG through our EEG laboratory services between January 2001 and December 2009 were thus scrutinized, and their clinical profile and follow-up data were obtained. A total of four subjects had SREDA (0.07%) in their EEG, and their mean age was 53.7 years. The duration of SREDA ranged from 10 to 60 seconds. SREDA was not associated with any clinical seizures during recording. Two patients remained asymptomatic on long-term follow-up. One patient was found to have idiopathic generalized epilepsy and another patient had Alzheimer disease during the follow-up. Mere presence of SREDA may not have any clinical significance at one point of time. The authors have also highlighted the possible pathophysiological basis of SREDA. Many features of SREDA still remain unresolved: why is it more common in the elderly population, why is its spatial distribution centered over temporoparietal region, why it appears mostly in wakefulness, and what is its pathogenesis? It would be worthwhile if compilation of cases reported world over are performed and further analyzed to reach at a common conclusion on its varied clinical presentations and EEG features.
成人亚临床节律性电发放（SREDA）是最罕见的良性癫痫样变异。这是一种已确立的 EEG 现象，当不熟悉该现象的人看到时，可能会将其误认为癫痫放电而产生混淆。我们对所有 EEG 报告进行了电子术语搜索，以确定那些报告显示 SREDA 和其他良性变异的记录。我们对 2001 年 1 月至 2009 年 12 月期间通过我们的 EEG 实验室服务进行 EEG 的 5200 名受试者的 EEG 报告进行了详细审查，并获得了他们的临床特征和随访数据。共有 4 名受试者的 EEG 中存在 SREDA（0.07%），他们的平均年龄为 53.7 岁。SREDA 的持续时间从 10 秒到 60 秒不等。SREDA 在记录期间与任何临床发作均无关。两名患者在长期随访中无症状。一名患者在随访中被发现患有特发性全面性癫痫，另一名患者患有阿尔茨海默病。SREDA 的存在在某一时刻可能没有任何临床意义。作者还强调了 SREDA 的可能病理生理学基础。SREDA 的许多特征仍未得到解决：为什么它在老年人群中更为常见，为什么其空间分布集中在颞顶叶区域，为什么它主要出现在清醒状态，以及它的发病机制是什么？如果对世界各地报告的病例进行汇编并进一步分析，以得出关于其不同临床表现和 EEG 特征的共同结论，那将是值得的。
