Dericioglu Nese, Khasiyev Farid, Arsava E Murat, Topcuoglu M Akif
1 Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
Clin EEG Neurosci. 2018 Jul;49(4):272-277. doi: 10.1177/1550059416688108. Epub 2017 Jan 24.
Frontal intermittent rhythmic delta activity (FIRDA), a transient rhythmic slow wave pattern over the anterior EEG leads, has been reported in a wide variety of cerebral lesions and different metabolic disturbances. Few authors have analyzed the frequency and clinical significance of FIRDA in the critical care setting. We aimed to better understand these issues in our intensive care cohort and if possible, try to delineate its underlying mechanisms.
Video-EEG reports of consecutive adult patients in the neurological intensive care unit (NICU) since 2009 were retrospectively reviewed to identify cases with FIRDA. Demographic, clinical, and laboratory data were obtained from EEG reports and patient charts. Age- and sex-matched patients with acute stroke, hospitalized in NICU and no FIRDA on video-EEG monitoring served as the control group.
Among 162 patients who underwent video-EEG monitoring, FIRDA was documented in 17%. Female prevalence was 50% and age ranged from 23 to 82 years. Twenty-three (82%) of patients with FIRDA had a diagnosis of stroke. Comparison of demographic characteristics, EEG findings, metabolic disturbances and prognoses revealed no differences between stroke cases with and without FIRDA, except for higher frequency of acute and chronic isolated posterior circulation infarcts in patients with FIRDA.
FIRDA is more commonly encountered in the neurocritical care setting as compared with outpatient EEG clinics. Our findings in stroke patients indicate that involved vascular territories may be related to the generation of FIRDA.
额部间歇性节律性δ活动（FIRDA）是脑电图前导导联上的一种短暂节律性慢波模式，已在多种脑损伤和不同代谢紊乱中被报道。很少有作者分析重症监护环境下FIRDA的频率和临床意义。我们旨在更好地了解我们重症监护队列中的这些问题，并尽可能阐明其潜在机制。
回顾性分析自2009年以来神经重症监护病房（NICU）连续成年患者的视频脑电图报告，以确定出现FIRDA的病例。从脑电图报告和患者病历中获取人口统计学、临床和实验室数据。在NICU住院且视频脑电图监测未出现FIRDA的年龄和性别匹配的急性中风患者作为对照组。
在162例接受视频脑电图监测的患者中，17%记录到FIRDA。女性患病率为50%，年龄范围为23至82岁。23例（82%）出现FIRDA的患者被诊断为中风。对人口统计学特征、脑电图结果、代谢紊乱和预后的比较显示，有和没有FIRDA的中风病例之间没有差异，除了出现FIRDA的患者急性和慢性孤立性后循环梗死的频率更高。
与门诊脑电图诊所相比，FIRDA在神经重症监护环境中更常见。我们在中风患者中的发现表明，受累血管区域可能与FIRDA的产生有关。
