Delta Brush Pattern Is Not Unique to NMDAR Encephalitis: Evaluation of Two Independent Long-Term EEG Cohorts
| Autor: | Leyla Baysal Kirac, Erdem Tüzün, Nerses Bebek, Gokcen Gundogdu, Ebru Altindag, Ebru Nur Vanlı-Yavuz, Betül Baykan, Ozlem Gungor Tuncer, Candan Gürses |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Delta Pathology medicine.medical_specialty Electroencephalography Receptors N-Methyl-D-Aspartate 050105 experimental psychology law.invention Cohort Studies Young Adult 03 medical and health sciences Epilepsy 0302 clinical medicine law medicine Humans 0501 psychology and cognitive sciences Nmdar encephalitis Autoantibodies Aged 80 and over Anti-N-Methyl-D-Aspartate Receptor Encephalitis medicine.diagnostic_test business.industry 05 social sciences Brush General Medicine medicine.disease Stroke Intensive Care Units Neurology Female Neurology (clinical) business Neuroscience 030217 neurology & neurosurgery Mesial temporal lobe epilepsy |
| Zdroj: | Clinical EEG and Neuroscience. 49:278-284 |
| ISSN: | 2169-5202 1550-0594 |
| DOI: | 10.1177/1550059417693168 |
| Popis: | Purpose. Although its specificity has not previously been investigated in other cohorts, delta brush pattern (DBP) is increasingly reported in the EEGs of patients with anti- N-methyl-d-aspartate receptor (NMDAR) encephalitis. Methods. We aimed to investigate the DBP in the EEGs of 2 cohorts; patients with change in consciousness for various causes monitored in the intensive care unit (ICU) (n = 106) and patients with mesial temporal lobe epilepsy (MTLE) with or without antineuronal antibodies (n = 76). Results. These patients were investigated for the presence of DBP, defined as an EEG pattern characterized by delta activity at 1 to 3 Hz with superimposed bursts of rhythmic 12- to 30-Hz activity. Two investigators blindfolded for the clinical and immunological data independently analyzed the EEGs for recognition of this pattern. An EEG picture compatible with DBP was observed in 4 patients; only 1 of them (1.3%) belonged to the MTLE group. She did not bear any of the investigated autoantibodies and was seizure-free after epilepsy surgery. In the ICU group, there were 3 additional patients showing DBP with various diagnoses such as hypoxic encephalopathy, brain tumor, stroke, and metabolic derangements. All of them had died in 1-month period. Conclusions. Our results underlined that DBP is not unique to NMDAR encephalitis; it may very rarely occur in MTLE with good prognosis after surgery and second, in ICU patients who have high mortality rate. Therefore, the presence of this pattern should alert the clinician for NMDAR encephalitis but other possible etiologies should not be ignored. |
| Databáze: | OpenAIRE |
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