Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea.
Department of Surgery, Keimyung University Dongsan Medical Center, Daegu, South Korea.
Clin EEG Neurosci. 2021 Jan;52(1):69-73. doi: 10.1177/1550059420922741. Epub 2020 May 15.
Frontal intermittent rhythmic delta activity (FIRDA), rhythmic slow wave pattern lasting several seconds over the anterior leads of electroencephalography (EEG), has been reported in a wide variety of clinical conditions. We investigated the clinical significance of FIRDA without structural brain lesions. We reviewed 7689 EEGs between October 2017 and September 2019 at a university hospital. Patients (age >18 years) who were confirmed to have "nonsignificant neuroimaging" were examined. Clinical data were retrospectively collected, and the estimated cause was carefully decided. We found 83 FIRDA among 7689 EEGs (1.08%). After patients with any structural lesion identified on neuroimaging were excluded, 37 FIRDAs were reviewed. There were 20 (51.35%) patients of metabolic encephalopathy. Six patients showed FIRDA due to neurodegenerative disease (16.21%). In addition, we found 6 (16.21%) of neurodegenerative disease and 5 (13.51%) of hypoxic encephalopathy (cardiac arrest). Four (16.21%) patients were related to systemic infection (10.81%), whereas 2 were related to encephalitis (5.40%). We demonstrated several potential etiologies, including metabolic encephalopathy, neurodegenerative disease, hypoxic encephalopathy, and infections, which should be considered in the case of FIRDA without structural brain lesions.
额部间歇性节律性德尔塔活动（FIRDA），即在脑电图（EEG）前导出现持续数秒的节律性慢波模式，已在多种临床情况下得到报道。我们研究了无结构性脑损伤的 FIRDA 的临床意义。我们回顾了 2017 年 10 月至 2019 年 9 月在一所大学医院进行的 7689 次脑电图。对被确认患有“无显著影像学改变”的患者进行了检查。我们回顾性地收集了临床数据，并仔细决定了估计的病因。我们在 7689 次脑电图中发现了 83 次 FIRDA（1.08%）。在排除了神经影像学上有任何结构性病变的患者后，我们回顾了 37 次 FIRDA。其中 20 例（51.35%）为代谢性脑病患者。6 例因神经退行性疾病出现 FIRDA（16.21%）。此外，我们发现 6 例（16.21%）神经退行性疾病和 5 例（13.51%）缺氧性脑病（心搏骤停）。4 例（16.21%）与全身性感染有关（10.81%），而 2 例与脑炎有关（5.40%）。我们证明了几个潜在的病因，包括代谢性脑病、神经退行性疾病、缺氧性脑病和感染，在无结构性脑损伤的情况下，这些病因都应被考虑。
