Department of Neurology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.
Department of Neurology, Kocaeli Derince Education and Research Hospital, Istanbul, Turkey.
Neurophysiol Clin. 2019 Jun;49(3):227-234. doi: 10.1016/j.neucli.2019.01.036. Epub 2019 Jan 31.
To investigate the clinical importance of intermittent rhythmic delta activity (IRDA) in terms of accompanying electrophysiological findings on EEG and their association with IRDA.
We retrospectively assessed all EEG studies recorded in our institution from 2011 to 2017. Patients with intermittent rhythmic delta activity (IRDA) in EEGs were included. Clinical data were collected from charts of the patients with IRDA.
We identified 69 EEGs with IRDA in 58 patients from a total of 18,625 EEG recordings. The most common IRDA type was frontal IRDA (FIRDA; 55%), followed by temporal IRDA (TIRDA; 28.9%). Unilateral (UL) distribution was present in 36.8% of FIRDAs and 95% of TIRDAs. The frequency of focal epileptiform discharges (FED) was 78.5% in UL FIRDA group and 89.4% in UL TIRDA group. Among the EEGs with FEDs, in UL FIRDA group 90.9% and in UL TIRDA group 70.5% of the FEDs were ipsilateral. Concordance of focal structural brain lesions and FEDs with UL TIRDA was 30.7%, and with UL FIRDA was 50%. UL FIRDA had a 71.4% positive predictive value for ipsilateral focal epileptic focus and UL TIRDA had 63.1%. The frequency of focal structural lesions and FEDs were significantly higher in the UL FIRDA group than bilateral FIRDA group (P=0.03; P=0.01). Among the patients with focal structural lesions, ipsilateral FED association is significantly higher in the UL FIRDA group than BL FIRDA group (P=0.03).
UL FIRDA is more likely to indicate a focal lesion and a focal epileptic focus compared to bilateral FIRDA, and it had similar characteristics to UL TIRDA. It can be considered that UL FIRDA has as good a lateralizing value for ipsilateral focal epileptic focus and focal lesion as UL TIRDA.
从脑电图的伴随电生理发现及其与 IRDA 的相关性方面，探讨间歇性节律性德尔塔活动（IRDA）的临床重要性。
我们回顾性评估了 2011 年至 2017 年在我们机构进行的所有脑电图研究。纳入脑电图中存在间歇性节律性德尔塔活动（IRDA）的患者。从具有 IRDA 的患者的图表中收集临床数据。
我们从总共 18625 份脑电图记录中确定了 58 名患者的 69 份脑电图存在 IRDA。最常见的 IRDA 类型是额 IRDA（FIRDA；55%），其次是颞 IRDA（TIRDA；28.9%）。单侧（UL）分布存在于 36.8%的 FIRDA 和 95%的 TIRDA 中。UL FIRDA 组的局灶性癫痫样放电（FED）频率为 78.5%，UL TIRDA 组为 89.4%。在具有 FED 的脑电图中，UL FIRDA 组中 90.9%的 FED 和 UL TIRDA 组中 70.5%的 FED 为同侧。UL TIRDA 与 FED 之间局灶性结构性脑病变的一致性为 30.7%，与 UL FIRDA 的一致性为 50%。UL FIRDA 对同侧局灶性癫痫灶的阳性预测值为 71.4%，UL TIRDA 为 63.1%。UL FIRDA 组的局灶性结构性病变和 FED 频率明显高于双侧 FIRDA 组（P=0.03；P=0.01）。在存在局灶性结构性病变的患者中，UL FIRDA 组与 BL FIRDA 组相比，同侧 FED 相关性明显更高（P=0.03）。
与双侧 FIRDA 相比，UL FIRDA 更有可能提示局灶性病变和局灶性癫痫灶，并且与 UL TIRDA 具有相似的特征。可以认为，与 UL TIRDA 相比，UL FIRDA 对同侧局灶性癫痫灶和局灶性病变具有同等的定位价值。
