da Silva-Júnior Francisco Pereira, Castro Luiz Henrique Martins, Andrade Joaquina Queiroz, Bastos Carla Guimarães, Moreira Camila Hobi, Valério Rosa Maria Figueiredo, Jorge Carmen Lisa, Marchiori Paulo Eurípedes, Nitrini Ricardo, Garzon Eliana
Department of Neurology, University of São Paulo, São Paulo, Brazil.
Department of Neurology, University of São Paulo, São Paulo, Brazil.
Clin Neurophysiol. 2014 Aug;125(8):1541-4. doi: 10.1016/j.clinph.2014.01.001. Epub 2014 Jan 10.
To describe serial electroencephalographic (EEG) findings of three patients with anti-NMDAR encephalitis.
Three women (age 15-34years) with confirmed anti-NMDAR encephalitis underwent serial EEG recordings. Continuous EEG for 72h was performed in one case and 3-day video-EEG monitoring was obtained in two cases.
Generalized rhythmic delta activity (GRDA) was found in all patients. GRDA persisted for hours, but was not continuous on a 24-h EEG recording, disclosed no frequency, voltage or field evolution, and was not seen on the first EEG of two patients. Extreme delta brush was noted in two patients who presented more severe disease. One patient presented seizures, which were electrographically and clinically different from the GRDA pattern and from dyskinetic movements.
Serial or continuous EEG may be necessary to detect GRDA in anti-NMDAR patients. To avoid unnecessary treatment, this pattern should not be interpreted as indicative of ictal activity, unless there is evidence of its ictal nature.
Our findings may contribute to the diagnosis of anti-NMDAR encephalitis in cases with characteristic clinical picture.
描述3例抗NMDAR脑炎患者的系列脑电图（EEG）检查结果。
3例确诊为抗NMDAR脑炎的女性患者（年龄15 - 34岁）接受了系列EEG记录。1例患者进行了72小时的连续EEG监测，2例患者进行了为期3天的视频EEG监测。
所有患者均发现广泛性节律性δ活动（GRDA）。GRDA持续数小时，但在24小时EEG记录中并非持续出现，未显示频率、电压或电场演变，且2例患者的首次EEG未出现该现象。2例病情较重的患者出现了极重度δ刷。1例患者出现癫痫发作，其脑电图和临床表现与GRDA模式及运动障碍不同。
对于抗NMDAR患者，可能需要进行系列或连续EEG检查以检测GRDA。为避免不必要的治疗，除非有证据表明其为发作性性质，否则不应将此模式解释为发作性活动的指标。
我们的发现可能有助于在具有特征性临床表现的病例中诊断抗NMDAR脑炎。
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