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Differentiating rhythmic high-amplitude delta with superimposed(poly)spikes from extreme delta brushes:limitations of standardized nomenclature and implications for patient management

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World Journal of Pediatrics 2024年第8期20卷 764-773页

作者： Rene Andrade-Machado elham abushanab Namrata D.Patel Avantika Singh Children’s Hospital of Wisconsin Wauwatosa:Milwaukee 8915 W Connell CtMilwaukeeWI53226USA

Background Following the standardized nomenclature proposed by the American Clinical Neurophysiology Society(ACNS),rhythmic high-amplitude delta activity with superimposed spikes(RHADS)can be reported as an extreme delta brush(EDB).The clinical implications of similar electrographic patterns being reported as RHADS versus EDB are important to *** aim to review the electrographic characteristics of RHADS,evaluate whether RHADS is seen in other neurological disorders,and identify the similar and unique characteristics between RHADS and EDB to ultimately determine the most accurate way to differentiate and report these *** believe that the differentiation of RHADS and EDB is important as there is a vast difference in the diagnostic approach and the medical management of associated underlying *** source We conducted an extensive search on MEDLINE and Pubmed utilizing various combinations of *** for“gamma polymerase and EEG”,or“RHADS”or“Alpers syndrome and EEG”or“EEG”AND“Alpers–Huttenlocher syndrome”.Results Three articles were found to be focused on the description of“RHADS”pattern in Alpers *** publication to date were found when searching for the terms“EDB”AND“children”,AND“infant”AND“adolescent”excluding“encephalitis”and“neonate”.Although RHADS and EDB appear as similar EEG patterns,meticulous analysis can differentiate *** is not exclusive to patients with Alpers–Huttenlocher syndrome and may manifest in regions beyond the posterior head *** to eye-opening and response to anesthesia can be two other elements that help in the differentiation of these *** RHADS is not exclusive to patients with AHS and may manifest in regions beyond the posterior head *** to eye-opening and response to anesthesia are features that help in the differentiation of these patterns.

关键词： Alpers-Huttenlocher syndrome Autoimmune encephalitis Extreme delta brush Neurological disorder Polyspike Rhythmic delta activity Rhythmic high-amplitude delta activity Seizure

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