Yoo Ji Yeoun
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Front Neurol. 2022 Aug 23;13:966480. doi: 10.3389/fneur.2022.966480. eCollection 2022.
Brief Potentially Ictal Rhythmic Discharges (BIRDs), initially described in neonates, have been shown to correlate with increased risk of seizures in both critically ill and non-critically ill adults. In critically ill patients, BIRDs are associated with acute brain injury and worse functional outcomes. In non-critically ill adults, BIRDs are seen in patients with epilepsy with a greater likelihood of having drug resistance. The location of BIRDs seems to better predict the seizure onset zone compared to other interictal epileptiform discharges. The definition of BIRDs includes Paroxysmal Fast Activity (PFA), and they have similar clinical significance regardless of the exact cut-off frequencies. Their potential as a biomarker for seizure activity and seizure onset zone has been suggested. In patients with status epilepticus, BIRDs also resolve or decrease when seizures resolve. Thus, if BIRDs are observed on scalp EEG, more extended EEG monitoring is recommended to estimate their seizure burden and to guide treatment. With the recent addition of BIRDs in the critical care EEG terminology, with future investigations, we may soon be able to reach a consensus about the definition of electrographic seizures and better understand their neurophysiology and clinical significance.
短暂性潜在发作性节律性放电（BIRDs）最初在新生儿中被描述，现已证明在重症和非重症成人中均与癫痫发作风险增加相关。在重症患者中，BIRDs与急性脑损伤及更差的功能预后相关。在非重症成人中，BIRDs见于癫痫患者，且更有可能存在耐药性。与其他发作间期癫痫样放电相比，BIRDs的位置似乎能更好地预测癫痫发作起始区。BIRDs的定义包括阵发性快速活动（PFA），无论确切的截止频率如何，它们都具有相似的临床意义。有人提出它们作为癫痫发作活动和癫痫发作起始区生物标志物的潜力。在癫痫持续状态患者中，癫痫发作缓解时BIRDs也会消失或减少。因此，如果在头皮脑电图上观察到BIRDs，建议进行更广泛的脑电图监测以评估其癫痫发作负荷并指导治疗。随着近期BIRDs被纳入重症监护脑电图术语，通过未来的研究，我们可能很快就能就脑电图癫痫发作的定义达成共识，并更好地理解其神经生理学和临床意义。
